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Glucose And Your Eyes

Nina Ghamrawi, MS, RD, CDE
December 5, 2023
December 5, 2023

When talking about Diabetes, our vision sometimes comes up in conversation. High glucose can lead to symptoms of blurred vision, yes, but there’s so much more. Newer evidence shows that elevated glucose leads to inflammation in other body areas, and also leads to nerve damage in sensitive nerve fibers… the nerve fibers in our eyes. Here’s how elevated glucose affects our eyesight.

Damage Occurs When Glucose is Elevated

Don’t wait until you get Diabetes to worry about eye damage. More and more research suggests that damage can begin to occur in the eyes gradually, even on a micro-level, when glucose is even pre-diabetic range.  This can lead to mainly either glaucoma or diabetic retinopathy.

Cataracts, Glaucoma and Diabetes

Cortical cataracts, are 2 to 5 times more likely in people with Diabetes than those without Diabetes. These can start at an early age, and progress faster and faster depending on age, years with high glucose, and level of glucose control. Cataracts happens because high blood glucose leads to oxidative stress, thereby damaging cells in your eye lens.

While glaucoma and cataracts are different conditions, they can be related in that cataracts can increase the pressure inside the eye, which in turn can cause or worsen glaucoma. In some cases, people with glaucoma may have cataracts as well, and in these cases it's very important to keep an eye on both conditions as both can make the other worse.

Let’s Talk Retinopathy

Diabetic retinopathy is a big concern in people with Diabetes, and affects around 1 in 3 people with Diabetes. In fact, it is the leading cause of preventable blindness in middle-aged adults. Diabetic retinopathy progresses between two stages: nonproliferative retinopathy, and then proliferative retinopathy.

Non-Proliferative Diabetic Retinopathy (NDPR) is the beginning of the vision loss, where high blood sugar over time leads to more and more inflammation in the nerves behind the eyes, causing gradual damage. Basically, small blood vessels in the retina that leak fluid or blood, leading to swelling or deposits of fatty material on the retina.

Proliferative Diabetic Retinopathy (PDR) is the more advanced stage of the disease, where new blood vessels grow on the surface of the retina or even the jelly part of the inside of the eye (this is not where they are supposed to grow). These new blood vessels are fragile and can easily bleed, leading to vision loss. PDR is more severe than NPDR and requires prompt treatment to prevent vision loss.

Treating Eye Issues Related to High Glucose

While taking medications prescribed by your doctor can slow progression of eye-related diseases, the most important means to control and reduce progression of retinopathy and vision loss is by:

Some manufacturing companies claim that taking supplements like antioxidants can help reduce inflammation and further reduce risks of retinopathy, but these studies are not proven. If you are looking for a way to reduce your retinopathy risks naturally, following the mediterranean diet has been shown to help in one major study.

The Takeaways

Regardless, talk with your doctor about your level of eye damage, get checked annually by an optometrist if you have Diabetes, eat healthfully, and try your best to keep cholesterol, glucose levels, and blood pressure normalized.

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