General Description
Diabetic retinopathy, the most common diabetic eye disease,* is
a potentially blinding condition that occurs when diabetes damages
the tiny blood vessels in the retina of the eye. As the disease
progresses to what is known as the proliferative stage, fragile
new blood vessels grow along the retina and in the vitreous. Without
timely treatment, these blood vessels can bleed, clouding vision
and damaging the retina. Diabetic retinopathy affects about half
of the 16 million Americans with diabetes.1
It is more common in people with Type I (juvenile onset) diabetes
than in those with Type II (adult onset) diabetes, and the odds
of developing the condition increase over time. In fact, nearly
all people who have had Type I diabetes for 15 years or more have
some degree of retinopathy. Type II patients taking insulin who
have had diabetes for 5 to 10 years have about a 2 percent incidence
of retinopathy, but this rate increases to more than 50 percent
in insulin-taking Type II patients who have had diabetes for more
than 20 years.1
*See also: glaucoma,
cataract
Standard treatment
Two types of treatment for diabetic retinopathy are very effective
in reducing vision loss from the disease: laser surgery and vitrectomy.
In laser surgery (which is generally used to stabilize vision
rather than improve it), a high-energy beam of light is used to
shrink or seal the abnormal blood vessels that form at the back
of the eye and thus stop them from leaking. Vitrectomy is a procedure
used to restore sight in eyes affected by excess blood in the
vitreous. In this procedure, the cloudy vitreous is removed and
replaced with a clear saline solution. Early vitrectomy is especially
effective in people with insulin-dependent diabetes, who may be
at greater risk of vision loss from bleeding into the eye.2
Although laser surgery and vitrectomy are very successful at protecting
vision, they do not cure diabetic retinopathy. This means diabetics
may need more than one treatment to protect their sight.2
Nutritional/lifestyle considerations
A number of factors believed to contribute to diabetic retinopathy
(such as smoking, hyperglycemia, blood platelet abnormalities,
and blood vessel constriction) may be influenced by dietary and
behavioral factors. Proper diet and exercise can help control
blood sugar levels, which may slow the onset and progression of
retinopathy and lessen the need for laser surgery for severe retinopathy.2
Oxidative damage appears to be a contributing factor in the development
of retinopathy,3-6 and studies indicate that
dietary antioxidants such as vitamins C and E, alpha lipoic acid,
and selenium may play a protective role.4-12
Antioxidant herbs such as Ginkgo biloba, bilberry, and grapeseed
extract may also be beneficial.13,14 Because
deficiencies of certain nutrients such as magnesium,15-18
vitamin A,19 and vitamin B-6 20
have been associated with the development of retinopathy, diabetics
should make sure their diets provide adequate amounts of these
nutrients. |
