Five things you should know about diabetic retinopathy

High blood sugar, also called hyperglycemia, is closely associated with diabetes. Over time, high blood sugar levels can damage the eyes, causing a condition called diabetic retinopathy. If left untreated, diabetic retinopathy can lead to permanent vision loss.

Diabetic retinopathy is a leading cause of blindness in adults, according to the National Eye Institute. It has also been shown to disproportionately affect the Latino community. People who have diabetes and are pregnant are also at higher risk.

The good news is that diabetic retinopathy is treatable, especially if it’s detected early. Doctors can work with you to slow, stop, or even reverse eye damage caused by high blood sugar. If you are diabetic, monitoring your blood sugar levels and scheduling annual exams with an eye care professional is key to preventing vision loss.

We sat down with M Health Fairview Endocrinologist Betsy Seaquist, MD, and service line director Heather Beadles, who helps oversee access to diabetes care at M Health Fairview, to learn more about what causes diabetic retinopathy and how you can prevent it.

Diabetic retinopathy is caused by blockages of tiny blood vessels in the eye.

Insulin is a hormone that breaks down sugars, or glucose, in the blood. High blood sugar, also known as hyperglycemia, occurs when the body doesn’t have enough insulin, or the insulin doesn’t work as well as it should. High blood sugar is associated with diabetes – a condition where the body doesn’t produce enough insulin to meet its needs.

Uncontrolled high blood sugar can affect the entire body. In the eyes, it can cause damage in the retina that leads to an overgrowth of fragile blood vessels. The retina senses light and sends images to the brain, making it necessary for sight. When these fragile blood vessels are present, they can bleed into the eye. At first, this may cause dark streaks or spots in your vision. Left untreated, it can lead to blindness.

“You need exposure to high blood sugar for a few years before diabetic retinopathy develops,” said Seaquist. “The longer someone has unmanaged high blood sugar, the higher their risk of eye disease.”

Many people show no symptoms of diabetic retinopathy.

Regular eye – and diabetes – screenings are crucial. Many people have high blood sugar for years before being diagnosed with diabetes. And diabetic retinopathy often doesn’t show symptoms, especially in the early stages.

“Patients can have significant retinopathy and show no symptoms, until a blood vessel bleeds in their eye and they lose their vision,” said Seaquist. “Those who are at risk for diabetes should be screened for diabetes and diabetic retinopathy annually.”

If you’re diabetic, it’s important to get an annual dilated eye exam.

Seaquist estimates that roughly 50 percent of people with diabetes will experience some changes to their eyes. Because diabetic retinopathy doesn’t always have symptoms – especially in the early stages – annual dilated eye exams are key to find and care for these changes.

It’s recommended that people with diabetes get a dilated eye exam at least once a year. During the exam, an eye care specialist will put drops in the eye to widen – or dilate – the pupil. This helps them see what is happening in the back of the eye and detect hard-to-find problems.

Diabetes and high blood sugar impact the body in a number of ways. M Health Fairview is committed to connecting patients to comprehensive specialty care within our system – making it as seamless as possible for our patients.

“It’s our responsibility to help patients with diabetes get connected to the eye care they need,” said Beadles. “We’re a large system with primary and specialty care. We can make an effort together to provide these comprehensive, preventative services that keep our patients healthy.”

Diabetic retinopathy is treatable.

An ophthalmologist can slow, stop, or even reverse the progression of diabetic retinopathy – it depends in large part on how early the disease is found.

Treatments include laser therapy that helps slow the formation of new, fragile blood vessels in the back of the eye. Another option is an injection that stops the growth of these blood vessels. An ophthalmologist will work with the patient to see how far along the disease is. They can then determine the appropriate type and frequency of treatment.

The most important thing to remember is that diabetic retinopathy doesn’t always lead to vision loss – it’s treatable with proper screening and monitoring.

If you’re at risk for type 2 diabetes, talk to your doctor and plan for annual screenings.

Many people have high blood sugar or diabetes without knowing. The Centers for Disease Control and Prevention estimates that over 30 million American adults have diabetes, and 1 in 5 don’t know it. The majority of people with diabetes have what’s known as type 2 diabetes, which tends to run in families.

“Most people with type 2 diabetes have high blood sugar for years before they get diagnosed,” said Seaquist. “Talk with your doctor. If you’re at risk for diabetes, it’s important to get a diabetes screening annually.”

Risk factors for type 2 diabetes include age, weight, and family history. They also include race and other social determinants of health that affect a person’s lifestyle and access to healthcare. Pregnant people can also develop what’s known as gestational diabetes during pregnancy. This can increase their risk for type 2 diabetes later on.

A primary care provider or endocrinologist can help determine your risk for diabetes and create an appropriate screening plan.