Improtance of Lifestyle Management to Prevent Diabetic Retinopathy

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INTRODUCTION

DIABETES is the disease which occurs when the pancreas does not secrete insulin or the body is unable to process it properly. INSULIN is the hormone that monitors the level of the sugar in the blood. DIABETIC EYE DISEASE refers to a group of eye problems that people with diabetes may face as a complication of diabetes that may cause severe vision loss or even blindness. DIABETIC RETINOPATHY is the most common diabetic eye disease and a leading cause of blindness. It involves small haemorrhages from broken arteries in the retina, with yellow waxy discharge or retinal detachment. Sometimes abnormal new blood vessels grow on the surface of the retina. It actually affects the circulatory system of the retina.

ASSESSMENT:
Diabetic Retinopathy is one of the important micro vascular complications of the Diabetes. The following data are the chief point of concern to prepare an educational session on Diabetes Retinopathy. * Diabetic Retinopathy is responsible for 4.8 % of the 37 million cases of blindness due to eye diseases throughout the world. (1.8 million people). * The proportion of blindness due to Diabetic Retinopathy is 3 – 7 % in South East Asia and Western Pacific, 15 – 17% wealthier Western community. * About 8000 people each year is becoming blind due to Diabetic Retinopathy. * Both Type I and Type II Diabetes are vulnerable but in prolonged cases (more than 20 years), the occurrence is high. * According to the Research to Prevent Blindness, by NISE, NSF, 65000 diabetics develop Proliferative Retinopathy every year.

PATHOPHYSIOLOGY:
Diabetes mellitus is a genetically influenced group of diseases that share glucose intolerance. It is characterized as a disorder of metabolic regulation as a result of deficient or malfunctioning insulin or cellular insulin receptors.Biochemistry involving the sorbitol formation and plays a role in the destruction of pericytes, which are cells that support the vascular endothelium. As the supportive pericytes perish capillary endothelium becomes compromised, resulting in the vascular leakage of blood, protein and lipids. This, in combination with thickened, glucose – laden blood produces vascular insufficiency capillary non perfusion retinal hypoxia, altered structure and decreased function.

RISK FACTORS:
Uncontrolled diabetes is the prime risk factor for retinopathy. Diabetic Retinopathy can usually be managed with combination of tight blood sugar control appropriate exercise and diet and early detection. The various risk factors are as follows: * High blood glucose level

* High blood pressure
* High blood cholesterol
* Renal disease pregnancy
* Smoking
* Poor environmental status
SIGNS AND SYMPTOMS:
* Blurred Vision
* Clinically Significant Macular Oedema (CSMO)
* Haemorrhage
* Abnormal vessel growth
* Retinal Detachment
* Glaucoma

FOUR STAGES OF DIABETIC RETINOPATHY:
STAGE| PICTURE|
STAGE 1: MILD NON PROLIFERATIVE RETINOPATHY: It is the earliest stage, micro aneurysms occur. They are small areas of balloon like swelling in the retina.| | STAGE 2: MODERATE NON PROLIFERATIVE RETINOPATHY: As the disease progresses, some blood vessels that nourish the retina are blocked.| | STAGE 3: SEVERE NON PROLIFERATIVE RETINOPATHY: Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment. | | STAGE 4: PROLIFERATIVE RETINOPATHY:In this stage the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. (Explanation continued)| |

GLAUCOMA:
There is fluid pressure increase in the eye that leads to Optic nerve damage and loss of vision. A person with diabetes in nearly twice as likely to get Glaucoma as other adults.

DETECTION OF THE DISEASE:
Diabetic Retinopathy and...
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