Nutrition and Eye Health (Part 1)

It’s been said that the eyes are the windows to the soul. Whether you believe that or not, your ophthalmologist (eye specialist), at least, is the one person who has the best view of the insides of your eyes and who can quickly spot any problems.

It’s well known that people with diabetes are at risk for several kinds of eye problems, including retinopathy, macular edema, glaucoma, and cataracts. The good news is that all of these conditions can be prevented and/or treated, which is why annual, dilated eye exams by an ophthalmologist are so important. Make sure, by the way, that you get your eye exams from a qualified ophthalmologist, preferably someone who has experience working with people with diabetes. Going to your local eyeglasses store for a quick eye check doesn’t cut it.

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Know Your Numbers
What can you do to keep your eyes in tip-top shape? As you well know, people with diabetes should try to keep their numbers in control: This means that your blood glucose, HbA1c, cholesterol, blood pressure, and microalbumin levels should be at or as close to your target range as possible.The higher your HbA1c level is above 7%, for example, the higher your chances of developing complications. On the flip side, for every 1% that you lower your HbA1c level, you lower your risk of complications by up to 40%.

Granted, it’s not always easy to get your numbers to your goal. But it’s possible. The first step is to “know your numbers.” Make sure you know your HbA1c, lipid profile, and microalbumin results. Ask what your blood pressure is at every visit. And just as you record your blood glucose levels in your logbook, write down your lab and exam results. Keep your appointments for your annual eye exam and ask about your results.

Next, find out your targets. Talk to your health-care provider about what your results should be. Then, if you’re not at your target, come up with a strategy to get yourself there. You may need a drug change, or you may benefit from making some changes in your food choices or physical activity plan.

Carbohydrate
No matter what your stance is on carbohydrate, what we do know is that it’s essential for health. “Carbs” provide our bodies with energy. Our brains use glucose, the basic building blocks of carbohydrates, for fuel.

However, as with all macronutrients, some carbs are better for us than others. And the types of carbs you eat can have an impact on your vision. A study published in the July issue of The American Journal of Clinical Nutrition links age-related macular degeneration (AMD) and its associated vision loss with the quality of carbohydrate that you eat. (AMD is the leading cause of blindness for people ages 50 and over.)

The researchers in this study found that men and women who consumed a higher–glycemic-index diet, compared to their peers, had a greater chance of developing AMD. The glycemic index (GI), you may recall, is a ranking of how quickly a carbohydrate-containing food gets converted to blood glucose. High-GI foods, such as white rice and white bread, can increase blood glucose levels more quickly than brown rice or whole-grain bread. And the researchers figured that about 20% of the cases of AMD may have been prevented if the participants had consumed a lower-GI diet (not a lower-carbohydrate diet, by the way).

Next week: Trans fat and some odd-sounding nutrients, and how they can impact your vision.

  • Norman Hinkle

    Whether you believe that or not, your ophthalmologist (eye specialist), at least, is the one person who has the best view of the insides of your eyes and who can quickly spot any problems.

    You are poorly informed that only an ophthalmologist is the one person who has the best view.. Optometrist also dilated all diabetic and have an excellent view of the retina. Your comment is the same as my saying only a doctor can best tell you how to properly eat and a dietican only plan meal. I have been an optometirst for 40 years and daily dilate diabetics and discuss their conditions with them. I agree that the doctors in retail establishments may not give the best care and dilate their patients, but the private practing optometrist do provide great diabetic care.

  • acampbell

    Thanks for bringing this up, and I do stand corrected. There certainly are well-qualified optometrists who can provide quality diabetes eye care. However, it’s very important that person with diabetes ask questions of any eye care provider, optometrist and ophthalmologist alike, regarding experience in working with people with diabetes. An eye care professional should have experience in being able to identify diabetes-related eye conditions, and either treat the problem or refer to a qualified professional who can. Another option, for those who don’t have access to an experienced eye care professional, is to have validated retinal imaging, a procedure that can indicate if problems are present without dilating the pupils.

  • judyp.

    At one time I was told that the reason my vision was getting much worse was because when I began to follow my diet really strick and my blood sugar reached normal range, the sugar was beginning to leave from the back of the lens of my eyes. Does anyone know any info about this? I have never heard of this before or since!!!

  • acampbell

    Hi Judy,
    It’s actually fairly common for people who are newly diagnosed with diabetes or who have been running high blood glucose levels to have blurry vision. This is because glucose can build up in the lens of the eye, causing it to swell, and therefore, leading to blurred vision. People are advised not to get a new glasses prescription, for example, when they’re first diagnosed with diabetes – as their glucose levels improve, the blurriness typically goes away (glucose is leaving the lens of the eye). Unless you wear glasses (or contacts) and got them during a period of uncontrolled blood glucose, your vision shouldn’t necessarily be getting worse as your diabetes improves. If anything, your vision would be getting clearer. Talk to your physician or an eye care specialist who is familiar with diabetes. He or she may suggest you get a dilated eye exam (which you should get at least annually, anyway) to determine the cause of your worsening vision.