Eye disease is one of the most serious and common complications of Type 2 diabetes – the chronic disease associated with obesity and lack of physical activity. If left untreated, diabetic eye disease can lead to blindness.
With the rates of diabetes in the Middle East estimated by the World Health Organisation to be the highest in the world, blindness from the disease is becoming an increasing problem. This is compounded by the fact that almost 75% of people with diabetes do not even know that they have eye complications.
“During the first two decades of disease, nearly all patients with Type 1 diabetes and up to 60% of patients with Type 2 diabetes have diabetic retinopathy.”
According to the World Health Organisation, in its first global report on diabetes (April 2016), the number of people living with diabetes has almost quadrupled since 1980 to 422 million adults, with most living in developing countries. Factors driving this dramatic rise include lack of exercise and obesity. The complications of diabetes include; heart attack, stroke, blindness, kidney failure and lower limb amputation.
The World Health Organisation is now calling for action on diabetes in 2016. They state that the Eastern Mediterranean region – which includes the Middle East – has the highest prevalence of diabetes in the world, affecting 43 million people. The prevalence rose from 6 per cent of the region’s population in 1980 to almost 14 per cent of adults over 18 years, in 2014, mostly because of rising Type 2 diabetes rates, due to excess body weight, physical inactivity and unhealthy diets.
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin -the hormone that regulates blood sugar- or when the body cannot effectively use the insulin it produces. High blood sugar levels are a common effect of uncontrolled diabetes and can eventually lead to serious damage of many of the body’s systems, especially the nerves and blood vessels.
Type 1 diabetes requires daily administration of insulin and the cause is not known or preventable. The majority of people with diabetes have Type 2 diabetes, in which the body cannot use insulin effectively and is the result of excess body weight and physical inactivity. Symptoms of the disease may be diagnosed only several years after onset, once complications have started. Until recently, Type 2 diabetes was seen only in adults, but it is now seen increasingly in children.
Dr. Paola Salvetti, Consultant Ophthalmologist and Expert in Medical Retina at Moorfields Eye Hospital Dubai, explains: “Diabetic retinopathy is more likely to occur the longer the patient has had diabetes. During the first two decades of disease, nearly all patients with Type 1 diabetes and up to 60% of patients with Type 2 diabetes have diabetic retinopathy.”
According to a Moorfields study specific to the United Arab Emirates, diabetic retinopathy is more common in men than women with diabetes, and increases with age and disease duration. Notably, as many as 74% of people with diabetes may not be aware that they have eye disease.
Dr. Paola Salvetti adds: “Diabetic retinopathy is directly linked to control of blood glucose levels. Diabetes is a chronic disease but with attention to diet, exercise and control of associated risk factors (such as hypertension – high blood pressure), it can be controlled and the risk of complications reduced. Even a simple daily walk can help. Moorfields recommends an annual eye examination for all people with diabetes who don’t have any complications, and more frequently if the patient has active diabetic retinopathy that may require treatment.”