COMPREHENSIVE DIABETIC CARE

COMPREHENSIVE DIABETIC CARE

Diabetes is a complex disease that can affect other areas of the body. These complications include heart disease, neuropathy, kidney failure, vision loss and diabetic foot wounds.
SaiNetra Comprehensive Diabetes Care offers diagnosis, assessment, education, management, and multidisciplinary care.

GENERAL DIABETES FACTS & INFORMATION

What is diabetes?
Diabetes is a disease in which the body is unable to properly use and store glucose (a form of sugar). Glucose backs up in the bloodstream — causing one’s blood glucose (sometimes referred to as blood sugar) to rise too high.
There are two major types of diabetes. In type 1 (fomerly called juvenile-onset or insulin-dependent) diabetes, the body completely stops producing any insulin, a hormone that enables the body to use glucose found in foods for energy. People with type 1 diabetes must take daily insulin injections to survive. This form of diabetes usually develops in children or young adults, but can occur at any age. Type 2 (formerly called adult-onset or non insulin-dependent) diabetes results when the body doesn’t produce enough insulin and/or is unable to use insulin properly (insulin resistance). This form of diabetes usually occurs in people who are over 40, overweight, and have a family history of diabetes, although today it is increasingly occurring in younger people, particularly adolescents.
How do people know if they have diabetes?
People with diabetes frequently experience certain symptoms. These include:

• being very thirsty
• frequent urination
• weight loss
• increased hunger
• blurry vision
• irritability
• tingling or numbness in the hands or feet
• frequent skin, bladder or gum infections
• wounds that don't heal
• extreme unexplained fatigue

In some cases, there are no symptoms — this happens at times with type 2 diabetes. In this case, people can live for months, even years without knowing they have the disease. This form of diabetes comes on so gradually that symptoms may not even be recognized.
Who gets diabetes?
Diabetes can occur in anyone. However, people who have close relatives with the disease are somewhat more likely to develop it. Other risk factors include obesity, high cholesterol, high blood pressure, and physical inactivity. The risk of developing diabetes also increases as people grow older. People who are over 40 and overweight are more likely to develop diabetes, although the incidence of type 2 diabetes in adolescents is growing. Diabetes is more common among Native Americans, African Americans, Hispanic Americans and Asian Americans/Pacific Islanders. Also, people who develop diabetes while pregnant (a condition called gestational diabetes) are more likely to develop full-blown diabetes later in life.

How is diabetes treated?
There are certain things that everyone who has diabetes, whether type 1 or type 2, needs to do to be healthy. They need to have a meal (eating) plan. They need to pay attention to how much physical activity they engage in, because physical activity can help the body use insulin better so it can convert glucose into energy for cells. Everyone with type 1 diabetes, and some people with type 2 diabetes, also need to take insulin injections. Some people with type 2 diabetes take pills called "oral agents" which help their bodies produce more insulin and/or use the insulin it is producing better. Some people with type 2 diabetes can manage their disease without medication by appropriate meal planning and adequate physical activity.
Everyone who has diabetes should be seen at least once every six months by a diabetes specialist (an endocrinologist or a diabetologist). He or she should also be seen periodically by other members of a diabetes treatment team, including a diabetes nurse educator, and a dietitian who will help develop a meal plan for the individual. Ideally, one should also see an exercise physiologist for help in developing a physical activity plan, and, perhaps, a social worker, psychologist or other mental health professional for help with the stresses and challenges of living with a chronic disease. Everyone who has diabetes should have regular eye exams (once a year) by an eye doctor expert in diabetes eye care to make sure that any eye problems associated with diabetes are caught early and treated before they become serious.
Also, people with diabetes need to learn how to monitor their blood glucose. Daily testing will help determine how well their meal plan, activity plan, and medication are working to keep blood glucose levels in a normal range.

HOWCAN DIABETES AFFECT THE EYE ?

Temporary Blurring -
Your vision can become blurred whilst your diabetes is being controlled. This is due to the swelling of the lens of the eye. Once your diabetes is stabilised it will clear.
Cataract -
This can occur in two forms. Young people with diabetes very occasionally develop a special type of cataract. Although their vision gets worse, it can be restored by surgery. Older people with diabetes can be especially prone to developing cataracts. Cataracts can be successfully removed by surgery and usually it is possible to insert a lens implant. However this is unsuitable for some people and you would be told if this is the case.
Diabetic Retinopathy -
The most serious diabetic eye condition involves the retina and is called diabetic retinopathy.
Background Diabetic Retinopathy -
This condition is very common in people who have had diabetes for a long time. Your doctor may be able to see abnormalities in your eyes, but there is no threat to your sight. There are two types of diabetic retinopathy, which can damage your sight. Both involve the fine network of blood vessels in the retina. They are described below.
Maculopathy -
This happens when the blood vessels in the retina start to leak. If the macula is affected, you will find that your central vision gradually gets worse. You may find it difficult to recognise people's faces in the distance or to see detail such as small print. The amount of central vision that is lost varies from person to person. However the vision which allows you to get around at home and outside (navigation vision) will be preserved. It is very rare for someone with maculopathy to lose all their sight.
Proliferative Diabetic Retinopathy -
Sometimes diabetes can cause the blood vessels in the retina to become blocked. If this happens then new blood vessels form in the eye. This is nature's way of trying to repair the damage so that the retina has a new blood supply. Unfortunately these new blood vessels are weak. They are also in the wrong place growing on the surface of the retina and into the vitreous jelly. As a result these blood vessels can bleed very easily and cause scar tissue to form in the eye. The scarring pulls and distorts the retina. When the retina is pulled out of position this is called retinal detachment.

• This condition is rarer than background retinopathy and is more often found in people who have been insulin dependent for many years.
• The new blood vessels will rarely affect your vision, but their consequences, such as bleeding or retinal detachment can cause your vision to get worse suddenly.
• Your eyesight may become blurred and patchy as the bleeding obscures part of your vision.
• Without treatment, total loss of vision can happen in proliferative retinopathy.
• With treatment most sight-threatening diabetic problems can be prevented if caught early enough

The Importance of Early Treatment

Your vision may be good and you may not be aware of any changes taking place. Most sight loss in diabetes is preventable.

• Early diagnosis is vital.
• Have an eye examination every year.
• Do not wait until your vision has deteriorated to have an eye test.