According to the Belgian Diabetes Liga, although no exact numbers are available, an estimated 10% of the population in Belgium suffers from diabetes, and another 6,5% is in the ‘grey zone’, showing abnormal glucose-management but not yet diagnosed with diabetes.
Early diagnosis: an early detection and first line treatment that can prevent complications such as diabetic retinopathy.
Read more on early Detection: NL |FR
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What is diabetes?
Diabetes is a chronic disease that occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces. Insulin is a hormone made by the pancreas, that acts like a key to let glucose from the food we eat pass from the blood stream into the cells in the body to produce energy. All carbohydrate foods are broken down into glucose in the blood. Insulin helps glucose get into the cells. Not being able to produce insulin or use it effectively leads to raised glucose levels in the blood (known as hyperglycaemia). Over the long-term high glucose levels are associated with damage to the body and failure of various organs and tissues1.
Types of diabetes
There are 3 main types of diabetes – type 1, type 2 and gestational.
- Type 1 diabetes can develop at any age, but occurs most frequently in children and adolescents. When you have type 1 diabetes, your body produces very little or no insulin, which means that you need daily insulin injections to maintain blood glucose levels under control.
- Type 2 diabetes is more common in adults and accounts for around 90% of all diabetes cases. When you have type 2 diabetes, your body does not make good use of the insulin that it produces. The cornerstone of type 2 diabetes treatment is a healthy lifestyle, including increased physical activity and healthy diet. However, over time most people with type 2 diabetes will require oral drugs and/or insulin to keep their blood glucose levels under control.
- Gestational diabetes (GDM) is a type of diabetes that consists of high blood glucose during pregnancy and is associated with complications to both mother and child. GDM usually disappears after pregnancy but women affected and their children are at increased risk of developing type 2 diabetes later in life
The impact on vision…
Diabetic retinopathy (DRP) is the leading cause of blindness in patients between the ages of 25 and 74 worldwide. The longer the diabetes, the higher the risk of complications. One of these complications is diabetic retinopathy. This is when high blood sugar levels cause damage to blood vessels in the retina. The most common symptoms are²:
- Micro-aneurysms: attenuation of the vessel wall of the retinal capillaries. They can leak, causing bleeding, edema, and hard exudates.
- Hemorrhages: The distinction between a small bleeding and a large micro-aneurysm is often difficult to make. A bleeding seeks the path of least resistance. The appearance of the bleeding then provides insight into the layer in which it is located. Superficial bleeding parallels the nerve fibers and will then be flame-shaped, while deeper bleeding is more rounded.
- Cotton-wool spots: appearing as fluffy white patches on the retina in fundoscopic exams. They are caused by damage to nerve fibers and are a result of accumulations of axoplasmic material within the nerve fiber layer.
- IRMA: Intra-retinal microvascular anomalies happen in pre-existing capillaries that have adapted to the new retinal blood flow distribution. They can be seen as serpentine vessel abnormalities with sharp bends, often intersecting with themselves, but not with the larger vessels. IRMA arise from the formation of collaterals (newly formed connection between blood vessels) and then occur in the vicinity of arterial occlusions and cottonwool spots. IRMA never form a loop and seem illogically directed. In contrast to neovascularizations, IRMA leaks only at the growth point. Recognizing IRMA is difficult: about 40% of diabetics have an IRMA.
- Venous beading: Veins that have the form of a sausage, because the barrel is dilated locally. They usually pass through areas with many occlusions. Venous beading can occur without other diabetes abnormalities. The prevalence of venous beading is no more than 7%.
All of these changes can decrease vision.
Stages of Diabetic Eye Disease
There are 2 main stages of diabetic eye disease.
NPDR (non-proliferative diabetic retinopathy)
This is the early stage of diabetic eye disease. Many people with diabetes have it.
With NPDR, tiny blood vessels leak, making the retina swell. When the macula swells, it is called macular edema. This is the most common reason why people with diabetes lose their vision.
Also with NPDR, blood vessels in the retina can close off. This is called macular ischemia. When that happens, blood cannot reach the macula. Sometimes tiny particles called exudates can form in the retina. These can affect vision too.
With NPDR, the patient’s vision will be blurry.
PDR (proliferative diabetic retinopathy)
PDR is the more advanced stage of diabetic eye disease. It happens when the retina starts growing new blood vessels (neovascularization). These fragile new vessels often bleed into the vitreous. If they only bleed a little, one might see a few dark floaters. If they bleed a lot, it might block all vision.
These new blood vessels can form scar tissue. Scar tissue can cause problems with the macula or lead to a detached retina. PDR is very serious, and can steal both central and peripheral vision.
How Omega-3s support Macular and Retinal Health
- The retina is a light-sensitive layer that lines two-thirds of the back of your eye. Similar to the film in a camera, it is responsible for receiving light energy and converting this to visual signals before the optic nerve carries them to the brain.
- The macula, located in the central portion of your retina, is responsible for your central vision and the ability to see fine details.
The retina and macular regions of your eye can deteriorate because of age and other factors. It’s essential to include eye-supporting nutrients — like Omega-3 into your diet to maintain your eye health3.