2. opto.ca
What is Diabetes?
Diabetes is a chronic disease that has no cure.
It is a leading cause of death in Canada.
Approximately 6% of Canadians have
diabetes.
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The Three Types of Diabetes
Type 1 diabetes occurs when the body
(specifically, the pancreas) no longer
produces insulin. We need insulin to use
sugar for energy.
Approximately 10 per cent of people with
diabetes have type 1 diabetes.
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The Three Types of Diabetes
Type 2 diabetes occurs when the pancreas
does not produce enough insulin or when
the body does not effectively use the insulin
that is produced.
90% of people with diabetes have type 2
diabetes.
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The Three Types of Diabetes
Gestational diabetes is a
temporary condition that
occurs during pregnancy.
It affects approximately 3.5%
of all pregnancies and involves
an increased risk of developing
diabetes for both mother and
child.
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Is Diabetes Serious?
If left untreated or improperly managed,
diabetes can result in a variety of
complications, including:
• heart disease;
• kidney disease;
• impotence;
• nerve damage;
• and eye disease!
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Diabetes and the Eyes
Diabetic eye problems include:
• fluctuating vision;
• cataracts;
• glaucoma;
• diabetic retinopathy.
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Fluctuating Vision
Diabetes can cause large shifts in
nearsightedness and farsightedness as
blood sugar levels fluctuate.
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Diabetes Increases Cataract Risk
A cataract is a clouded lens
within the eye.
Treatment is surgical
removal of the cataract and
replacement with an
artificial lens.
Cataract surgery is very safe
and has excellent outcomes.
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Diabetes and Glaucoma
Diabetes can lead to blood
vessel development in the
drainage angle of the eye.
This can raise eye pressure
and cause glaucoma.
The optic nerve gets
damaged and peripheral
vision is lost.
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Diabetic Retinopathy
One-third of diabetics have diabetic
retinopathy.
It is now the most common cause of
blindness under age 65, and the most
common cause of new blindness in North
America.
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Diabetes and the Eyes
Many patients with retinopathy don't have
any warning symptoms in the early stages
of the disease.
Routine eye examinations are the best
method of detecting and preventing the
development of severe blood vessel
damage in the eyes.
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Will I Get Retinopathy?
The single most
important risk factor
is the length of time
you've had diabetes.
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Will I Get Retinopathy?
Type 1 patients usually don't develop
retinopathy until at least five years after
the onset of the disease.
After 15 years with diabetes, however, 98%
of patients demonstrate some retinopathy.
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Will I Get Retinopathy?
In type 2 diabetes, the development of
retinopathy happens much more quickly.
One-fifth of type 2 patients show signs of
retinopathy when their diabetes is first
diagnosed.
Ultimately, diabetes will cause changes in
the eyes for 78% of type 2 patients.
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What Happens With
Diabetic Retinopathy?
Diabetes damages
the tiny blood
vessels in the part
of the eye called
the retina.
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What Happens With
Diabetic Retinopathy?
Over time, the ability to deliver blood (and oxygen)
to the retinal tissues of the eye is lost.
New, abnormal, weak blood vessels may start to
grow.
The new or existing blood vessels become "leaky."
Blood and fat (blood lipid) can seep out of these
damaged capillaries.
This makes the retina bleed and swell.
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Treatment: Laser Photocoagulation
for Mild or Non-Proliferative Retinopathy
The bright light of the laser is used to burn
and seal off the damaged blood vessels so
the leakage stops.
The treatment is painless, using only eye
drops to freeze the eye.
The goal is to slow down the rate of visual
loss.
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Treatment: Laser Photocoagulation
for Mild or Non-Proliferative Retinopathy
The laser is used to create scars throughout the
peripheral retina.
A scarred retina needs less oxygen than an untreated
retina — therefore the new abnormal blood vessels are
no longer needed.
This is a much more extensive technique, performed
during three to four sessions over several weeks.
The periphery of the retina has many nerves, and some
patients find these treatments more uncomfortable.
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Vitrectomy
If bleeding in the eye is extensive, or
associated with the formation of scar tissue
and detached retinas, vitrectomy surgery
may be necessary to remove scar tissue and
the inner “jelly” of the eye.
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Reducing the Risk of
Diabetic Complications
Early diagnosis and treatment – see your
family physician for routine physicals.
If you have diabetes – tight blood sugar
control, control blood pressure and blood
lipids, and…
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Reducing the Risk of
Diabetic Complications
Routine eye examinations
Diabetic retinopathy often
presents with no visual
warning signs!
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Reducing the Risk of
Diabetic Complications
All patients diagnosed with
type 1 or 2 should visit an
optometrist or ophthalmologist
for an eye exam.
During the exam, eye drops will
be used to dilate the pupils and
a thorough retinal examination
will be done.
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Reducing the Risk of
Diabetic Complications
People with diabetes should
have an eye examination at
least once a year.
Routine eye examinations
are the best method of
detecting and preventing
the development of severe
damage in the eyes.
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