Caring For Your Eyes

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We continue our part 4 interview with Dr. S.S. Gill, Consultant Ophthalmologist at Hospital Fatimah about Diabetes Mellitus and eye complications.

It is estimated that 1.4 million Malaysian diabetics are walking around unaware that they have diabetic retinopathy that can lead to total blindness. A lot of times this is because of poor awareness of the complications of diabetes mellitus.

What are the other steps that diabetics can take apart from the regular eye checks that you have suggested in order to help reduce their risk of developing diabetic eye complications?

Good control of diabetes mellitus is the key to slowing down the complications of diabetes mellitus in the eye as well as to other organs. The best way to know whether your blood glucose control is good is to measure your blood glucose levels frequently at home with a glucose monitoring machine called a glucometer.  Keep a small booklet and write down blood glucose results in a tabular fashion with the date, time of blood check, and whether the test was done fasting or after a meal.

Do indicate in the booklet, the time of the last meal before the check was done. Better still, indicate the kind of meal that was taken. Do show this booklet to your physician when you go for your regular diabetic follow-ups. This booklet with the readings tabulated gives a lot of information to your physician should he need to adjust your diet or your diabetic medication.

Many diabetics make a mistake of only checking fasting blood glucose levels. Fasting blood glucose levels alone is not reflective of the actual blood glucose control. Check blood glucose measurements at different times of the day and even 1 or 2 hours after a meal. Even a random blood glucose reading is helpful – it’s really like doing a spot-check on the patient, says Dr. Gill.

It is also important to have other special blood tests that reflect 3-month blood glucose readings. This test is called haemoglobin A1C (HbA1c). The test is recommended to be done every 3 to 6 months. It is recommended that people with diabetes maintain an HbA1c level below 7%. Studies have shown that for every 10% reduction in elevated HbA1c levels, there is an associated 39% reduction in the risk of diabetic eye complications.

Dr. Gill adds that another step that can slow down the progression of diabetic eye complications is good control of blood pressure or hypertension. High blood pressure (hypertension) can also damage blood vessels in the nerve of the eye (retina) and can cause diabetic eye disease or retinopathy to progress.

Research shows that keeping blood pressure as close to normal as possible can help prevent the onset and progression of retinal damage. Experts recommend that people with diabetes keep their blood pressure at or below 130/80 mm Hg to prevent long-term eye complications. Here too, self-measurements of blood pressure is useful in helping your physician who is monitoring and managing the diabetes mellitus.

Next issue: more tips on how diabetics can reduce their risk of developing eye complications and what to expect during an eye examination. For more information, contact Gill Eye Specialist Centre at 05-5455582, or email gilleyecentre@dr.com.