Mitigating the side effects of Diabetic Retinopathy
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The main side effect or consequence of the condition in patients with advanced stages of diabetic retinopathy and/or macular oedema is reduced visual acuity. In this respect, low-vision aids ensure patients with severely affected eyesight can still lead a relatively independent lifestyle. Special training, called vision rehabilitation, can teach patients the skills they need to live with low vision. A low-vision specialist can help patients identify the most suitable combination of aids according to their needs.
Amongst others, low-vision aids include: magnifying glasses and screens, telescopic lenses, lenses with special filters, high-intensity reading lights, and specially designed computers and tablets.
Tobacco. Smoking is the main modifiable risk factor. People with diabetes who also smoke face a significant increase in the risk of developing cardiovascular disease, mortality, stroke and heart attack compared with non-smokers.
Alcohol. If people with diabetes consume alcohol but without eating any food, it can trigger low blood sugar levels. Individuals with high lipid levels (cholesterol and triglycerides), neuropathy, liver disease, pancreatitis, pregnant women and those with a history of alcoholism should abstain from alcohol.
Obesity. The initial aim of the treatment is to reduce the percentage of body fat to levels that improve the associated risk factors, thus minimising complications and improving quality of life. Small amounts of weight loss (5–10%) result in better control of clinical, metabolic and psychological factors.
Diet. Individuals with diabetes comment that dietary control is one of the hardest aspects to manage. Diet should be adapted to each patient’s individual characteristics, for example their drug therapy (tablets or insulin injections), whether they are overweight, risk factors such as high blood pressure, high cholesterol levels, etc. It should be varied, enjoyable, easy to follow, take account of the patient’s age and preferences, and they must be able to integrate the diet into their social, occupational and family lifestyle as they will follow it for their entire life.
Carbohydrates are essential to help control blood sugar levels as they have an influence of up to 50% on any variation in glycaemic response.
Exercise. Nowadays, people with diabetes are advised to complete a minimum of 2–3 hours/week of moderate physical activity, spread out over at least 3 days per week, and to avoid more than 2 consecutive days without any exercise. Patients who take insulin must measure their capillary blood sugar level before and during exercise, and perform extra analyses after exercising to avoid delayed hypoglycaemia associated with the physical activity.
Importance of and tips for sleeping well. A good night’s sleep helps the pancreas regulate blood insulin levels. It is very important that patients get good quality sleep; therefore, they should stick to regular sleeping patterns and develop some healthy habits, such as avoiding coffee and smoking before bedtime and afternoon naps.
Sexuality. Diabetes can produce sexual dysfunction in approximately half of patients and this proportion increases as the condition advances. Diabetes has a negative effect on sexual function due to a combination of factors, such as high blood pressure, high cholesterol and even some of the medications, together with the psychological factors linked to the disease. These elements are treated with drug therapy, sexual therapy and by controlling the underlying risk factors.
Travelling. Travelling with diabetic retinopathy does not represent a problem for patients who preserve their visual function, so long as they follow their normal drug or insulin therapy, control their diet very closely and take special care when eating foods in strange situations.
Social and emotional support. Obtaining support, encouragement and empathy from others is a vital consideration for maintaining motivation and ensuring well-controlled diabetes. Patients should speak with their friends and family, so they know how they feel, what they need and what they do not want. In this regard, other people with diabetes can also be a great source of support.