A global report by the World Health Organisation identifies the Eastern Mediterranean and the Middle East as the area with the highest prevalence of diabetes in the world, with an estimated 43 million people affected.
The prevalence of the disease has risen in the adult population of the region from 6 per cent in 1980 to almost 14 per cent, mostly because of increasing rates of type 2 diabetes, which is secondary to excess body weight, physical inactivity and unhealthy diets. Until recently, type 2 was only seen in adults, but it is now also seen in children.
High blood sugar levels are a common effect of uncontrolled diabetes and can eventually cause serious damage to many systems, especially the nerves and blood vessels, including the retinal vessels in the back of the eye, causing
diabetic retinopathy.
The eye is one of the most vascularised organs in the body and so is especially vulnerable to damage caused by diabetes. In fact, eye disease is one of the most serious and common complications of type 2 diabetes and if left untreated it can lead to blindness.
The most common complication is diabetic retinopathy, which is a result of blood vessel damage in the retina, with bleeding and abnormal growth blocking vision. It is more likely to occur the longer the patient has had diabetes. During the first two decades of the disease, nearly all patients with type 1 diabetes and up to 60 per cent of type 2 diabetics have some degree of diabetic retinopathy.
According to a study specific to the UAE, as many as 74 per cent of diabetics may not be aware that they have eye disease. The typical symptoms of retinopathy to look out for include sudden changes in vision, blurred vision, eye floaters and spots, distorted vision, and fluctuating vision.
Patients should also be aware of associations as new research has shown, for example, that obstructive sleep apnoea can increase the risk of diabetic retinopathy in type 2 diabetics.
Diabetes is a chronic disease but with attention to diet, exercise and control of associated risk factors, it can be controlled and the risk of complications including serious eye problems can be reduced. It’s critical for all diabetics who don’t have any complications to go for an annual eye examination and more frequently if the patient has active diabetic retinopathy that requires treatment.
— The writer is Consultant Ophthalmologist and an expert in medical retina at Moorfields Eye Hospital Dubai
