December 12, 2019
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Proper treatment, early detection can lower odds of diabetic eye disease

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Audrey R. Talley Rostov

As the population of adults with diabetes grows and ages, so grows the risk for associated diabetic eye disease, including cataracts.

According to the National Eye Institute, prolonged disease status increases the risk for vision loss as a result of diabetic eye diseases. Early detection and treatment can decrease odds for blindness by 95% through proper diet, exercise and medication.

In a study published in the World Journal of Diabetes, Hasan Kiziltoprak, MD, FEBO, FICO, of Ulucanlar Eye Education and Research Hospital in Turkey, and colleagues wrote cataracts are “one of the major causes of visual impairment” in patients with diabetes.

The researchers examined a number of pathogeneses of cataract in diabetes, including polyol pathway, osmotic and oxidative stress, and autoimmune effects.

Audrey R. Talley Rostov, MD, director of cornea, cataract and refractive surgery at Northwest Eye Surgeons in Seattle, has seen an increase of cataract incidents in patients with diabetes.

Talley Rostov said, as a surgeon, she looks for a history of diabetes and poor blood sugar control in determining diabetes-related cataract.

“Decreased vision in a younger patient with diabetes should prompt a search for the etiology,” Talley Rostov said. “If retinal complications are ruled out by optical coherence tomography and exam, then the surgeon or clinician should take another look at the cataracts.”

Kiziltoprak and colleagues wrote the utilization of cataract surgery, which used to be a more conservative approach, has “contributed to improved visual outcomes” in patients with diabetes. Preoperative counseling, including monitoring and evaluating glycemic control, are important tools to use when examining patients with diabetes.

In a study published in Diabetes/Metabolism Research and Reviews, Jocelyn J. Drinkwater, of the University of Western Australia, and colleagues wrote that glycemia is “the only consistent modifiable risk factor” of cataracts in patients with diabetes, while diabetes duration, sex, blood pressure and aspirin use were not.

When it comes to educating and advising patients on the issue of cataracts in diabetes, Talley Rostov said stressing proper management is important.

“It’s best to get blood sugars under good control and to check blood sugars and hemoglobin A1c on a regular basis,” she said. – by Earl Holland Jr.

References:

Drinkwater JJ, et al. Diabetes Metab Res Rev. 2019;doi:10.1002/dmrr.3073.

Kiziltoprak H, et al. World J Diabetes. 2019;doi:10.4239/wjd.v.10.i3.140.

Diabetic eye disease resources. www.nei.nih.gov/learn-about-eye-health/resources-for-health-educators/diabetic-eye-disease-resources. Last updated July 5, 2019.

Disclosure: Talley Rostov reports no relevant financial disclosures.