Did you know diabetes can cause sight loss? Dr Evelyn Mensah, Clinical Lead for Ophthalmology at London North West University Healthcare NHS Trust explains: “If you have diabetes, you’re at risk of a diabetic eye disease called diabetic retinopathy.”
Screening helps to protect your eyes
Diabetes causes the level of glucose in our blood, also known as blood sugar, to rise.
“When it’s high for a long time, blood sugar can damage blood vessels, arteries, organs and tissues, including those in the retina, at the back of the eye,” says Dr Mensah. “When the blood vessels in our eyes are affected, it can damage the retina which needs a healthy blood flow to help us to see.
“Not everyone with diabetes will be affected but if left untreated it can cause sight loss. Free regular screening from the NHS means we can detect it and treat it early to protect your sight and prevent or slow further damage.”
‘I thought I just needed new glasses’
Bernadette Warren, 55, from Surrey was registered sight impaired in 2016, 20 years after being diagnosed with type 1 diabetes.
“Diabetic eye screening is so important because you won’t usually have any symptoms,” Bernadette says. “Something could be happening, and you won’t know.”
The mum-of-two, pictured, already had the first stages of diabetic retinopathy which hadn’t needed treatment when she noticed she was having difficulty reading.
Thinking she simply needed new glasses, she eventually made an appointment for an eye test. But the optician spotted a change in her condition and arranged an urgent appointment with her ophthalmologist, who diagnosed a serious eye complication known as diabetic macular oedema.
“My blood sugar levels were the best they’d ever been but now I couldn’t see so well. I’d thought I just needed new reading glasses and I’d been putting it off.
“When I was diagnosed with sight loss, the repercussions were enormous. No one wants to lose their sight. I cried for six months.
“For my own sake, my husbands, my children’s, and others around me, I’ve made this into a positive thing in my life. It was hard. But there’s a lot of support out there.”
Who should attend screening?
Everyone who’s 12 or over with diabetes is invited to a screening appointment every one to two years. How often depends on the results from your past two screening tests.
“Exercising, giving up smoking, and keeping our blood pressure and cholesterol to healthy levels all help to reduce the risk of diabetic eye disease and other problems too,” says Dr Mensah. “Diabetic eye screening is necessary from age 12 years old, whether you’ve had diabetes for a long time or not.
“People with South Asian and Black African or Caribbean heritage are more likely to develop type 2 diabetes, often at a younger age. This means they live longer with the condition and consequently are at risk of complications for a longer period of their life.
“There is also evidence suggesting that they may also be more susceptible to developing diabetic retinopathy. Why these differences occur is complex, so if you are eligible for diabetic eye screening, please come as it can protect your eyesight.
“Good eye care means going to the optician regularly too. And if you notice any changes between your diabetic eye screening appointments, contact your optometrist or optician straight away for advice.”
“Live well with diabetes
Bernadette, a former teacher, runs a support group for people with diabetic sight loss. She says: “When we’re diagnosed with diabetes, we’re told a lot about the complications, and it can be frightening.
“We hear about what we must do to avoid them, and it can feel like you’ve brought them on yourself. But we need to get rid of that stigma.”
Dr Bharan Kumar, a GP working in Slough, Berkshire, agrees.
“Having diabetes can feel overwhelming and affect your wellbeing, especially when there are complications, so don’t be afraid to say if things feel too much.
“We’re here to help you. Taking your medicines as advised and testing your blood sugar means we can work together to help you maintain safe, consistent levels of blood sugar, reducing the risk of complications.”
Bernadette adds: “People are also afraid of hearing bad news. But screening and diabetic health check-ups are a positive experience – if there’s a problem, it means you can get treatment and there are so many new treatments and drugs these days.”
Screening and checks for people with type 1 and type 2 diabetes include:
- Diabetic eye screening
- Blood tests every 3-6 months, to measure how well your blood sugar is controlled
- An annual foot check to keep your feet healthy
- An annual review and health check that includes your weight, blood pressure and risk of other illnesses associated with diabetes.
Dr Kumar says: “Attending screening and these regular checks, will help identify people’s risks of or early signs of complications, when we can do something about them. But in between these checks, please speak to your GP practice or specialist team if you’re unwell, have an injury that isn’t healing, or repeated infections – don’t wait for your routine appointment.
“And because diabetes puts you at risk of becoming severely ill from common viruses, such as flu and COVID-19, or measles, I’d also recommend checking if you’re up to date with your vaccinations.”
Further support:
- If you take medicines for your diabetes, you’re entitled to free prescriptions with a medical exemption certificate. Contact the NHS Help with Health Costs helpline on 0300 330 134.
- On sight loss, contact the RNIB helpline on 0303 123 9999 or email helpline@rnib.org.uk or find local support with RNIB’s Sightline Directory.
- On living with diabetic macular oedema, call The Macular Society helpline on 0300 303 0111
- Contact the Diabetes UK helpline for help or advice about living with diabetes, on 0345 123 2399 or email info@diabetes.org.uk
- Visit NHS.uk for further information on sight loss or about diabetic eye screening, help to quit smoking, or cut back on alcohol.
Did you know?
According to Diabetes UK, 850,000 people in the UK could have diabetes without knowing. Often it doesn’t have symptoms, but signs include:
- feeling very thirsty
- peeing more often than usual, particularly at night
- feeling very tired
- weight loss and loss of muscle
- wounds or infections that don’t heal, or frequent episodes of thrush
- blurred vision.
If you (or someone you know) has any of these, or you know you’re at risk of diabetes, contact your GP
practice as soon as possible.
Type 1 diabetes is where the body can’t produce insulin, a hormone that manages glucose levels in the blood. It’s often diagnosed in childhood but can affect people at any age.
Type 2 diabetes is where the body isn’t producing enough insulin or can’t use it properly. It can be linked with our lifestyles and weight and is preventable.
Gestational diabetes mellitus can happen during pregnancy when the body can’t make enough insulin. It usually resolves after the birth, but individuals remain at risk in subsequent pregnancies and of developing type 2 diabetes.
Find out if you’re at risk of diabetes by using Diabetes UK’s Know your Risk tool.