November 14th is World Diabetes Day.
So what, you may ask.
And what has this do with you and me?
Well, there are 3.9 million people living with diabetes in the UK. That’s more than one in 16 people in the UK who has diabetes. This means that almost everyone knows someone who is diabetic, and almost every family will have a member that has the condition.
What is diabetes? The official definition is “Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces”. When this happens the effect over time of uncontrolled diabetes is that it commonly leads to serious damage to many of the body’s systems, especially the heart, blood vessels, eyes, kidneys and nerves.
What causes diabetes?
The amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach).
When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it’s broken down to produce energy.
However, if you have diabetes, your body is unable to break down glucose into energy. This is because there’s either not enough insulin to move the glucose, or the insulin produced doesn’t work properly.
There are two recognised types of diabetes. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn’t make enough insulin. The prevalence of type 2 diabetes has risen dramatically over the last 30 years. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is the condition in which the pancreas produces little or no insulin by itself.
There are many more people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes. This is sometimes known as prediabetes. If your blood sugar level is above the normal range, there is a greater risk of developing full-blown diabetes.
One of the main effects that occur when the blood sugar is too high is that the very small blood vessels in the body are damaged. This will affect every part of the body, from your feet to your head. This is why there is a greater risk of cardiovascular disease, where the diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries.
Nerve damage occurs where the excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications, where left untreated, cuts and blisters can develop serious infections, which due to the impaired blood supply often heal poorly Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhoea or constipation.
The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system.
Diabetes can damage the blood vessels of the retina at the back of the eye (diabetic retinopathy), which can have a life changing effect, potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.
Diabetes and your eyes
When you have an eye test, we look at one of the few places in the body where we can actually see blood vessels in their natural place, the back of the eye. The changes in these blood vessels can be seen when the optician uses their ophthalmoscope. However even better are the Retinal Photographs, where we can compare the images from previous tests and easily see if there are any changes. Even if you haven’t been tested before, we can study the photographs and look for any warning signs.
Recently we have invested in an amazing instrument at our Spondon practice, the Optical Coherence Tomographer (OCT). This very new instrument does something that we haven’t been able to do before, look at the cell structures underneath the retina, so that we can detect the changes in the small blood vessels before they show to our naked eye. OCT is a non-invasive imaging test that uses light waves to take cross-section pictures of your retina, so is an incredibly powerful tool.
When people have been diagnosed with diabetes, they are enrolled in the NHS diabetic screening system. This is usually an annual check where drops are put in your eye to make the pupil very big, and a photograph is taken of the retina at the back of the eye. The images are studied by technicians, and a report is sent to your General Practitioner.
If you do not know that you are a diabetic, your only screening is when you have your eye test, and this is why I felt that it was so important to invest in the wonderful OCT equipment, to ensure that we can help look after your health. Retinopathy frequently has no symptoms until it is well advanced, so the importance of regular eye tests cannot be understated.
For more information about diabetes, your eyes, the eye test or to book an eyetest, call our friendly team at Mark Davis Opticians on 01332 666 760 (Spondon) or 01530 832 769 (Whitwick) or email us at firstname.lastname@example.org.