Diabetes and Diabetic Retinopathy: Common Risk Factors
The most common risk factors in the case of a type 2 diabetes include:
– being older than 30 years of age,
– having a sedentary lifestyle, and
– having a body mass index of 25 to 29.9.
In addition, with hereditary antecedants of diabetes, delivering a baby that weighed over 9 lbs (4000 g), the presence of cardiac risk factors, a history of hypertension and abnormal cholesterol levels also increase the risk of contracting diabetes.1
Whilst it is well know that the risk of being diabetic increases with age, younger, obese patients, who have multiple diabetic antecedants accrue their risk of being affected by type 2 diabetes.
Ethnicity can also play a role: certain ethnic groups are at higher risk, including Native Americans, African-Americans, Latinos, Pacific Islanders, and Asians.
Anyone older than 45 years should have a screening test for diabetes, and the examination repeated every 3 years.
Those with risk factors, especially those who are overweight and have a positive family history of diabetes, should be screened at a younger age.
A standard as to the minimum age for such an examination is not known through empirical research, but in my practice, I have even come across 10-year-olds with type 2 diabetes. A fasting blood test will determine your fasting blood sugar. According to the American Diabetes Association, a blood sugar value higher than 100 mg/dL is an indicator of prediabetes, and over 125 mg/dL denotes the existence of diabetes.2
Once diagnosed with prediabetes, it is important that the patient engage / increase his/her moderate intensity physical activity (such as brisk walking) to at least 150 minutes a week, and lose weight. The weight loss need not be dramatic, because losing 7% of your body weigh (which corresponds to 10 to 15 pounds, can decrease the risk of developing diabetes.1
It is paramount that patients are duly informed that the primary goal of exercise and weight loss is not their physical appearance, but to augment their body’s ability to use insulin and process glucose, thereby helping the body’s insulin-producing cells, the beta cells, to function better. Research shows that this protocol can be very helpful.2
If diet and exercise are not effective, a medication called metformin, which is indicated for type 2 diabetes, can halt the progression from prediabetes to diabetes.3 It is an off-label use, but many physicians precribe metformin to prevent the development of diabetes.3
It is really important that patients are made aware that this is done to prevent them from being prediabetic.4
People can be directed to use in-person and online Diabetes Prevention Programs offered by the CDC.
For those who have diabetes, the risk of developing diabetic retinopathy and diabetic macular edema depends on two factors:
– the duration of diabetes and
– the level of glucose control.
If a person has had diabetes since their childhood, he or she is likely to have some form of diabetic retinopathy by the age of 80 years. However, having mild retinopathy may not impact visual acuity, and effective treatments are available for more serious forms of eye disease. This is why, regular eye examinations are extremely important; it is possible to have 20/20 visual acuity whilst having damage in the back of the eye. Ophthalmologists have the necessary tools to detect and treat such a condition. By alleviating the ocular complications of diabetes, vision can be maintained.