Keep your eyes healthy

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1 Keep your eyes healthy Prevent diabetes problems What are diabetes problems? All people with diabetes have a risk of developing damage to their eyes as a result of poor blood glucose (sugar) control. Too much glucose (sugar) in the blood for a long time causes diabetes problems. High blood glucose levels can damage many parts of the body, such as the eyes, heart and blood vessels. Diabetes problems are serious and can be scary. You can take steps to prevent them or slow them down. Facts about diabetes and eye disease: Diabetes can damage your eyes. Finding and treating eye problems early can help prevent loss of vision. Having a complete eye exam every one to two years is important. It can save your sight. Problems to Report to Your Doctor Difficulty reading Blurring or double vision Difficulty seeing at night Pressure or pain in your eyes Blind spots Dark spots Flashing lights Rings around lights Floaters Cobwebs in field of vision What are diabetes eye problems? Cataract: The lens of the eye becomes cloudy. laucoma: The pressure inside the eye rises and damages the optic nerve. Cataracts and glaucoma can also affect people without diabetes. Retinopathy: The blood vessels in the back of the eye become weak and bleed and cause damage to the retina. The retina is the coating inside the back of your eye that reacts to light so you can see.

2 What is diabetic retinopathy? Diabetic retinopathy is the most common cause of blindness in North America. Both people with Type 1 and Type 2 diabetes are at risk for retinopathy. Those with type 2 should be tested for retinopathy at diagnosis. People with type 1 are recommended to have screening done 5 years after diagnosis in all those that are age 15 or older. There are many small blood vessels going back and forth across your retina. Over time high blood glucose levels and high blood pressure can weaken these vessels, making them leak or bleed. The bleeding can lead to blurred vision and blindness. There are two types of retinopathy which can make people lose their sight. Proliferative retinopathy- New blood vessels grow on the surface of the retina and attach to the clear vitreous that makes up the inside of the eye. If these blood vessels bleed; they cause clouded vision and can damage the retina. Macular edema- Damaged blood vessels around the retina can leak fluid and lipids into the macula (the part of the retina responsible for central vision); this can swell and cause macular edema. Macular edema creates blurred vision and if not treated quickly, may lead to substantial loss of vision. Normal Vision Decreased Vision with Macular Edema

3 Prevention of retinopathy Research has shown that diabetic retinopathy can be prevented or slowed down through good control of blood glucose levels. In fact, studies have shown that a 1% reduction in A1C can reduce the risk of retinopathy by 25%. Other important factors which decrease the risk are maintaining a good blood pressure and good cholesterol levels. How is diabetic retinopathy treated? A laser beam can be used to repair damaged blood vessels and may help to prevent blindness. Laser surgery may bring back some vision already lost, and will usually keep the retinopathy from getting worse. Remember: In its early stages, diabetic retinopathy can be successfully treated. How to protect your eyes: Manage your blood glucose (sugar) levels Manage your blood pressure Have an annual eye exam to help to detect major eye problems. If you smoke, stop! Eye complications can be prevented with proper treatment. The most important thing to know about eye complications is that they are frequently SILENT. You may not see or feel any change in your vision. These changes can only be discovered during a special examination where you have dilated pupils. Important things to remember: Ask your family doctor to refer you to an expert experienced professional for retinopathy testing. Tell the eye doctor that you have diabetes. The eye exam should be one where you have dilated pupils. Regular Dilated Pupils Pupils People with sight threatening diabetic retinopathy should be assessed by an opthalmologist for the necessary treatment.

4 Staying Healthy Everyday with Diabetes eat a balanced diet < eat three meals each day < choose 2-3 starch servings with every meal < eat more fibre-rich foods (whole grain breads, beans & lentils, high fibre cereals, fruits & vegetables) < choose plenty of vegetables < eat fruit with your meals < try to avoid fruit juice < eat a small amount of protein at every meal < limit salt (sodium) and highsalt foods < avoid deep fried foods and other high fat foods < go easy on the extras (avoid butter, gravy, cream sauces, sugar and cream in coffee) check your blood glucose (sugar) often and keep readings close to the recommended ranges < 4-7mmol/L before meals < 5-10 mmol/l 1-2 hours after meals < can you see a pattern between the food you eat, your activity and blood glucose results? < if blood glucose remains high contact your doctor or diabetes health professional don t smoke take your medications check your feet everyday < look for swelling, redness, blisters, cuts or sore toenails. be physically active < be active for at least 30 to 60 minutes most days. brush and floss your teeth and gums daily

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There may be no symptoms at first. Eye problems can. You can help prevent eye problems. Just because you have

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