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Diabetes Mellitus and Diabetic Retinopathy

What is Diabetes Mellitus?

Diabetes mellitus is a group of metabolic diseases characterized by elevated blood glucose levels resulting from defects in insulin secretion, insulin action, or both. Generally, when people talk about "diabetes" they are speaking about diabetes mellitus. There is also a rare disease called Diabetes Insipidus in which the body produces large amounts of dilute urine, and is a separate disorder.

How is Diabetes Mellitus diagnosed?

Diabetes may have symptoms in some people, and no symptoms in others. Generally, insulin-deficient diabetes mellitus presents with thirst and frequent urination. Untreated, this condition may cause a person to lose consciousness and become very ill. Diabetes associated with being overweight may have minimal symptoms and may be diagnosed when your doctor orders blood tests. Your doctor measures the glucose level in the blood. A single, elevated measurement may be all that is needed to make the diagnosis. In some circumstances, it may require multiple measurements of blood glucose to determine the degree of impairment of glucose metabolism. Some women have problems with glucose metabolism only when they are pregnant. Some people develop diabetes that resolves if they lose weight. Your doctor is the person to help you determine if you might have diabetes.

How is Diabetes Mellitus treated?

Proper treatment depends on the degree of impairment in regulation of blood glucose. Very elevated levels may require hospitalization. Insulin injections are appropriate for some people. Oral agents (pills) are appropriate for other people. Diet and exercise may be all that is required in yet other people. Your doctor will tell you the proper treatment for your circumstance.

How important is it to control blood sugar levels?

Studies suggest that good control of blood sugar levels decreases the risk of complications from diabetes.

What are complications of Diabetes Mellitus?

Problems caused by diabetes can be thought about as acute (sudden) problems and long-term problems:

• Sudden problems may be confusion or loss of consciousness.
• Long-term problems include heart disease, stroke, nerve problems (neuropathy), kidney problems (nephropathy) and eye problems.

How can Diabetes Mellitus affect the eyes?

Fig. 1 Retiopathy may cause blood vessels in the retina to become damaged or grow abnormally.

• Retinopathy - diabetes may cause blood vessels in the retina (the light sensitive lining of the eye) to become damaged (leaky or blocked) or grow abnormally [See figure 1]. Retinopathy is rare before the age of 10 and the risk increases with the length of time a person has diabetes. Treatments such as laser or other surgery may be helpful to prevent visual loss or restore sight.
• Cataract - may occur at a younger age in diabetic patients.

How often should I have my eyes examined if I have Diabetes Mellitus?

An eye exam is probably a good idea at time of diagnosis. Depending on what is found, your doctor will recommend follow-up visits based on your condition. Eye exams should be done at least yearly.

Where can I find more information regarding diabetes in children?

Juvenile Diabetes Research Foundation
American Academy of Pediatrics policy statement: Eye examination in infants, children, and young adults by pediatricians