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EVERY 30 MINUTES ANOTHER AMERICAN TRAGICALLY GOES BLIND FROM DIABETES . . . UNNECESSARILY

NANCY'S STORY 

(A true story with some of the details changed to protect privacy)

Each person dealing with vision loss is unique; each has a compelling 

Nancy's Story 

(A true story with some of the details changed to protect privacy)

Each person dealing with vision loss is unique; each has a compelling story to tell. No two people experience vision loss in the same way. Many feel sadness, grief, anger, and other powerful emotions. Vision loss inevitably results in lifestyle changes and has an impact upon the lives of family and friends. 

Nancy is a quiet-spoken woman who has strong opinions and religious beliefs and a dignified determination. She describes herself as extremely stubborn! Nancy was diagnosed with diabetes fifteen years ago, at age 58. Ten years later, she was diagnosed with diabetic retinopathy. 

Diagnosed With Diabetes

"To be quite honest, when I was first diagnosed I don't really remember what I was told," Nancy said. "I think I was so shocked to realize I was falling prey to diabetes, a disease I thought I would never get. 

"Today I take four shots a day: two of insulin and two of Byetta which is supposed to help you process your food more slowly. Before I used insulin, my sugar levels were up and down, but now I don't have to worry because the insulin has helped to level them out to near normal levels.

"Of course I have to watch what I eat, but over time I've learned what I can and cannot eat. After a while, you learn to listen to your body and it tells you when things are right or wrong.

"If my sugar gets too low, I feel disoriented. I used to wake up in the middle of the night in a sweat and wonder what was wrong. I'd test my blood sugar and see that it was too low, but after having a couple of Life Savers or some orange juice, I found that within minutes I felt so much better. 

"When my blood sugar is too high, I get tired and sleepy. I had this one bad experience-I ate about six Clementines.  You know they're very small but I really enjoyed them!  I fell asleep right after eating them. 

"My husband called me from New York and said I sounded funny and he asked where our son Roger was. I said I didn't know, and I couldn't remember his number. Apparently my speech was very slurred, and I guess I sounded stupid to him. When I came to, there were six guys in the room - my son, paramedics, police, and the fire brigade! My son thought I'd had a stroke.  But when the sugar goes too high, it can be dangerous and cause a coma if you're not careful.  I was lucky! 

"They gave me something and I was all right, but it scared me enough that I've been much more careful ever since. 

Then I Was Diagnosed With Diabetic Retinopathy

"I was not prepared for vision problems," said Nancy. The doctor who first treated me for diabetes didn't mention that I needed to take care of my eyes. He didn't suggest that I should have my eyes examined every year for a checkup. I don't think too many people know that you can lose your vision to diabetes.

"My vision problems began just over ten years ago. The doctor diagnosed diabetic retinopathy. I then went to an ophthalmologist who specialized in laser treatments. He told me that although I had a problem with scar tissue, he would try to fix it. I had an operation, called a vitrectomy and this helped to remove some of the scar tissue.  I'm still considered legally blind, but I can see a little better since I had the operation. 

"Some days I see better than others - I can see - I just don't see clearly. I can see an entire person when they're standing in front of me but I don't see them clearly, and my peripheral vision is not so good. When someone comes up from behind me and stands to my side, I don't always notice them.

Sometimes I Don't Recognize My Beautiful Red Hibiscus

                         

"I have a beautiful red hibiscus in my garden, but I've learned that red is one color I have problems with. I just don't recognize it. If I'm sitting right in front of it I can see the red, but I have to be almost on top of it! I have real problems when labels are written in red ink on a colored background. For example, my vitamin bottle has a blue background and red ink. Well, you can forget it! It's impossible to read. I don't think it's so much to do with poor contrast - it's just that red seems to be a more difficult color for me to recognize.

"My vision changes along with my blood sugar levels. For example, I take 46 units of insulin in the morning, and 20 at night. If at lunch time I decide to eat a lot of fruit, which I'm not supposed to, then my sugar jumps up and my vision will change. 

"By the time night comes around, my sugar drops and I can see better. At the beginning it's disconcerting, but you really do get to know your body. It's hard to explain. 

"I just never realized this earlier. I never knew it affected the eyes - I just kept changing my glasses. I didn't know any different at the time.

 

"The nature of diabetic retinopathy is that no two days are the same. Much of what I see depends on the weather! If it's sunny out, or when I'm in a car it's harder to see. If it's a darker day, I see better. It's always difficult when I go into a restaurant, because of the change of light. At first I can't see well until my eyes adjust. If I go into a store when it's very bright, it also makes me very confused. Glare bothers me so much. 

What I Remember . . .

                    When I Found Out I Was Legally Blind

"I don't recall much discussion with the eye doctor who told me I was legally blind. Or if there was, it went straight through my head. I'm not one that wants to go and ask for help. Maybe it's my pride and now all of a sudden I have to look to everyone else for help. It was hard to accept.

Blood Sugar, Blood Pressure, Cholesterol

"But what I have to emphasize is that you must keep your blood sugar, your cholesterol, and your blood pressure in control. These are the most important things you must do because if you don't, your condition will get worse. With diabetes I learned that if I do everything I'm supposed to do, my vision seems to stabilize. My diabetes is now under control, and I'm able to use my magnifier, so I can see to test my sugar. 

"My current eye doctor is very pleased with my condition. I'd advise anyone with diabetes to visit both a medical doctor and an eye doctor - and follow their instructions.  And if you're not satisfied, get a second opinion.

"I now need to look into special lighting. I have no problems reading outside with my magnifier where its bright natural light, but the lighting in my home isn't bright enough for me to read.

 "I also had a lamp with a magnifier that I hoped could help me do my cross stitch, but it just didn't work out. I tried a reading machine that was similar to a CCTV, but it had a moving tray that made me feel nauseous.

Driving and Vision Loss

"The thing that hurt me most - in fact it was devastating - was when I couldn't renew my driver's license. This happened about ten years ago. I used to drive a lot. My husband has always been busy with his work and I spent a lot of time on my own. I used to drive regularly from South Carolina to Maine to see my kids and grandkids. I did everything, and then all of a sudden I couldn't drive - I couldn't even go to the store on my own. You can imagine how I felt!

"I'm a pretty independent person, but there comes a time when you have to accept and realize that you mustn't do anything foolish because of things that can happen. So now I don't drive - I'm housebound. If I want to go to the store, I need to take somebody with me.  If I want to see the canned goods, I have to hold them real close to my eyes so that I can see what they are.

"It's also hard to go to a restaurant and read the menu because the restaurants are so dark.

I Wonder if Maybe It Was My Own Fault

"I don't get angry about these frustrations because I wonder if maybe it was my own fault in the first place. Maybe I should have watched my weight more when I was younger. I was always very heavy and I was always on diets. But I'm sad about the things that I can't do. I feel sometimes as though I'm imposing on other people, although they tell me I'm not.

Shocking Statistics

25% of individuals with insulin dependent diabetes will have some level of diabetic retinopathy within 5 years.  Even worse, 60% will after 10 years and 80% after 15 years.

I Take a Particular Interest in Helping People with Diabetes 

My name is Dr. David Littlefield and I am especially interested  in helping people with diabetes preserve their eye sight.  Think for a moment what it would be like for you to lose your vision like Nancy.  Not only would it affect your ability for normal living but would prevent you from enjoying the special things in life.  Surveys have shown that next to being diagnosed with cancer that losing vision is what people fear the most.

Nancy's story would have been better if she had realized that diabetes is a leading cause of blindness and that early diagnosis and treatment can do much to preserve vision.

New Research in Preventing Blindness

Your doctor has told you that if you have diabetes you must have your eyes examined every year.  Scientists have long known that high blood sugar levels from diabetes damage blood vessels in the eye, but they didn't know why or how. Now a Michigan State University scientist has discovered the process that causes retinal cells to die which might lead to new treatments that halt the damage. 

Diabetic retinopathy is a common side effect of diabetes and the leading cause of blindness in young adults in the United States. It's estimated that between 45 percent and 50 percent of people diagnosed with diabetes have some degree of diabetic retinopathy.

Research by Susanne Mohr, Michigan State University Associate Professor of Physiology, found that when blood sugar levels are high special cells that protect the blood vessels in the eye die. This leads to the vascular damage associated with diabetic retinopathy.

Another New Research Study

At the University College Dublin scientists have determined that treatment of diabetic blindness should look at protecting the neurons responsible for color vision in the eye and not just targeting the blood vessels as currently practiced. 

 Nearly 2.5 million people worldwide are blind due to a complication of diabetes called diabetic retinopathy. This disorder activates the growth of new leaky blood vessels in the eye and is responsible for the death of photoreceptors, the neurons that send visual messages to our brain. Until now, scientists were unclear if the changes to vessels and neurons occurred independently of one other. Questions were also asked about which type of retinal neuron is most likely to die as a result of the raised glucose levels seen in diabetes. 

Dr. Kennedy and his team found that new blood vessels and the neuronal cell death in diabetic retinopathy can occur independently of each other. In addition, they identified that cone photoreceptor neurons, those involved in color vision and which we use to see during daylight, are most affected by the high glucose levels.

Current treatment for diabetic retinopathy tries to prevent the growth of new blood vessels in the late stage of the disease. This research suggests a need to also protect the neurons before the disease progresses to the late stage.   

Old Technology

Traditional testing measures your visual acuity (as expressed in numbers like 20/20) and your ability to see high contrast detail.  This test was invented by a Dutch ophthalmologist in 1862. As you would expect, any test 148 years old could hardly be expected to reveal subtle defects in vision. And yet it is the test that is still used as the primary test of vision by the majority of eye doctors. People are still being told they have perfect vision just because they have 20/20!

Most eye doctors recognize bleeding that occurs in the eye as a result of diabetes. However, new research shows that even before bleeding occurs damage has occurred in the eye.  I think (and probably so do you if you've stayed with me this far) that it makes sense to discover diabetic changes before bleeding occurs, before you become aware of decreased vision. 

Annual Eye Examinations Recommended

Eye doctors and the American Diabetic Association recommend yearly eye exams for persons with diabetes. Many people don't realize that diabetes can have a profound effect upon your vision . . . until it's too late. Protect your vision before major damage occurs. If serious damage is found new treatments by retinal surgeons can be sight saving.

Important vitamins and supplements that research has shown may help to prevent damage to the retina

Benfotiamine 

High blood sugar damages the small blood vessels of the retina in 4 different ways. 

Benfotiamine prevents the damage that occurs by blocking at least 3 of the 4 "pathways". One of these pathways occurs when excess sugar combines with protein in the cells and causes advanced glycation end-products (AGEs) to form. AGEs are like "biological cement". They "gunk up" the cells and blood vessels of the retina and prevent them from functioning properly.

Vitamin D

A recent article in the Kansas City Star has highlighted that in the past year a test that checks vitamin D levels in the blood has surged in popularity among doctors. The article continues  on  . . .  

 "If you have symptoms that include fatigue and muscle aches and pains, don't be surprised if your doctor suggests a vitamin D blood test at your next visit. Because of widespread deficiencies, some doctors won't need any symptoms to suggest it.

"Vitamin D is important to bone and muscle health for certain, but vitamin D experts worry that D deficiency is implicated in cancers, autoimmune diseases, heart disease, diabetes, high blood pressure, infections and depression, to name but a few ailments. 

"Carla Aamodt, an internal medicine doctor with St. Luke's Health System, said about half the patients she was testing were vitamin D deficient, with many more "borderline."  Michael Kennedy, a family physician at the University of Kansas Hospital, said a third to a half of the patients he tested in the past year have been deficient.  Cardiologist James O'Keefe said general population statistics were worse. Lack of sun exposure, the natural way the body makes vitamin D, helps explain the deficiencies.

 "If a patient is deficient, levels usually can be increased with vitamin D supplements, typically in pill form. Food sources of vitamin D, such as ocean fish and fortified milk, typically can't be consumed in enough quantities to do the trick.

"For borderline and slight deficiencies, doctors often recommend an over-the-counter supplement containing 1,000 IU or more of vitamin D3 (cholecalciferol), taken daily. Most multivitamins contain 400 IU of vitamin D.  Up to 2,000 IU in a daily vitamin D supplement is considered safe for most people without worry of toxicity. Severe deficiencies may require a prescription."

If there is any single nutrient that holds the potential for enormous health and performance gains it is Vitamin D. Vitamin D suppresses the growth of abnormal retinal blood vessels.  It helps to keep the immune system under control and enhances the function of the pancreas which makes insulin. It also lowers insulin resistance.

Delta Tocotrienol

A recently discovered member of the Vitamin E family that is emerging as having additional health benefits over "conventional" vitamin E is delta tocotrienol.  Several research groups have shown that it may be beneficial for pre-diabetics and diabetics. One benefit is that it helps to prevent "angiogenesis" - that "out-of-control" growth of unwanted blood capillaries in the retina. 

 Additionally, in animal studies, scientists have seen a significant beneficial overall effect of increased insulin sensitivity, lower triglycerides, and lower LDL (bad cholesterol) levels. 

It keeps cholesterol from sticking to the artery wall which causes hardening of the arteries.  The normal form of Vitamin E is much less effective.  Make your appointment for a visit now.

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