EP #9: Unveiling the Connection: Diabetes and Eye Health with Dr. Falco

Do you know that diabetes goes beyond blood sugar levels? Wondering how your eyesight can be impacted by diabetes? Tune into our enlightening episode of the Jazzy Eyes podcast where your hosts, Dr. Laura Falco and Jeremy Wolfe, delve into the crucial link between diabetes and eyesight. Dr. Falco unravels the mystery around hemoglobin A1C, the red flags that your fluctuating blood sugar levels might be indicating about your vision, and the latest diabetic research that’s shaking up the medical world.

We don’t stop at the theory, as Dr. Falco walks us through the severity of diabetic retinopathy - a condition that could lead to permanent vision loss if not managed properly. Discover the importance of adopting a team approach in managing diabetes, involving not just your ophthalmologist but also endocrinologists, nutritionists, and more. Get a glimpse into innovative technologies such as continuous glucose monitoring that are aiding patients in keeping their diabetes under control. This episode is a must-listen for everyone as it emphasizes the power of regular monitoring, lifestyle alterations, and open communication with your healthcare team in ensuring the best outcomes for diabetic patients. So, grab your headphones and join us on this journey of exploring the indispensable connection between diabetes and your vision health.

For more information visit: JazzyEyes.com

or contact: (954) 473-0100

Transcript

Speaker 1: 0:03

Welcome to the Jazzy Eyes Podcast. Taking care of your vision with expert precision. Here's your host, dr Laura Falco.

Jeremy: 0:16

Hello everyone and welcome to the Jazzy Eyes Podcast. I'm your co-host, jeremy Wolfe, and I'm here with the host, dr Laura Falco. Dr Falco, we were just talking about diabetes. It is upcoming Diabetes Awareness Month and we're talking a little bit about the illness and as it pertains to your eyesight. But something I didn't ask on the last segment that I think we should clarify right now for listeners can you just give a basic definition for those that maybe don't know as to what diabetes is in the first place?

Dr. Falco: 0:47

So diabetes is diagnosed by your blood sugar level, right? So patients will typically have blood work done fasting in the morning and there are certain readings. If you're over, say, 120 in the morning, you're going to be diagnosed fasting, you know, as a diabetic, because you could should be 100 or less, right? There are other tests and I'm actually glad you asked this I was going to talk about this. It's called a hemoglobin A1C, so it's a percentage. Now hemoglobin A1C is basically giving you an idea of, over the course of the life cycle of a red blood cell, which is about 90 days, how high and low your blood sugar fluctuates because diabetics tend to peak high and then come down. So they're these huge swings in their blood sugar level and that can also go along with like frequent urination, frequent thirst, like their symptoms that patients can have or sometimes they really don't know they have any symptoms. So the higher the highs, the lower the lows, the bigger, like the peak to the trough you know like is up and down, the larger the number will be the percent. So if somebody has a number that's say 8, 9, 10%, they're definitely a diabetic. You know you're looking to have a number under 6%. Some people want it under 5.5%. So this is basically telling you over the span of 90 days if your blood sugar, if your body's regulating in a tight zone or if your body's having trouble and it's going up, down, up down. And these peaks and valleys are quite far from one another. The further they're apart, the higher their percentage the number will be. So that kind of like ties into the newest research is showing that the HbA1c everyone thought was like the, the, the answer is kind of not the best prognostic indicator for us to see what you know, how much damage we might see in the back of the eye. We used to think if we heard an A1c level was like 12 or 13%, we were going to see a disaster in the back of the eye, all these bleeds and stuff. And now we're we're kind of not and and they're tying it in eye signs at least, and microvascular blood vessels to more of.

Dr. Falco: 3:20

Is the patient on insulin or not versus A1c? Because typically the harder the diabetes gets to control they end up on insulin and that seems to correlate more with changes in the back of the eye. But just to name a couple of symptoms a patient might have. Who's diabetic eye wise? There is a. Your prescription can change quite a bit and you're not sure why. So your glasses that worked all of a sudden don't work. These can actually change your glasses prescription because it changes the physiology of the lens in the eye and that changes the prescription Fascinating. Yeah, so sometimes we actually won't prescribe glasses until somebody's stabilized, because what I see one day isn't going to work three months later. If they're A1C, or if everything gets vastly changed, you can have patients with more dry eye than typically, because diabetes and dry eye are linked together. Can you back up?

Jeremy: 4:28

a second there. What's the A1C again?

Dr. Falco: 4:31

It's the hemoglobin A1C. That's that percentage test. That gives you an idea because it follows the life of that red blood cell. The hemoglobin on the red blood cell is a 90-day life. Whether or not the patient is again the peaks and valleys, if they are far apart or if they are close together, that will affect the result. So your percentage will be high or low and you really want a lower number for that. You don't want big peaks and valleys.

Jeremy: 4:57

Thanks for clarifying. It's Monday and I'm slow processing things. I need to hear things twice sometimes.

Dr. Falco: 5:03

Yeah, no, the other big. You know there's cataracts that also can come earlier with diabetics than non-diabetics, and all of those are pretty treatable. The one that is that you really have to look out for is called diabetic retinopathy. So the eyes are amazing. It's like one of the few places you dilate the pupils, you look at the back and you're looking at the microvascular. You're able to visualize arteries and veins in basic in their natural habitat without being very invasive. And whatever you're seeing in the back of the eye you have to understand is what the rest of the body is looking like. You just can't see it. But we get a window in, literally through the pupil and we examine the back of the eye and patients who have uncontrolled diabetes and have diabetic retinopathy have a lot of changes back there. And then we sometimes that's how they're diagnosed because they don't even know they have it. But it's very important because that's where you can really have permanent vision loss. That's not correctable anymore. So you know, just to like kind of summarize, diabetes management for the patients is definitely a team approach. It's not just me, it's not just an ophthalmologist, it's not just an endocrinologist, it's co managing these patients with the primary, if that's, you know, to keep them abreast the endocrinologist, a nutritionist, for a lot of patients because the root cause is being obese, and then the ophthalmologist, when it's getting to a point where they need treatment because of what we're seeing in the back of the eye for the diabetes, and it is, it's basically communication. The patient has to understand. The patient has to come in, you know, and and realize that this is there's a group of us who can manage, you know. There's wound care also, to be honest, podiatry and wound care, because they can have, they can have um sores, you know, and and neuropathy. So it's a big issue. It's affecting a ton of people.

Dr. Falco: 7:10

There are newer technologies that patients are using to keep it under control, because if your diabetes is under control, then all these other side effects, you know, all these other sequela they don't happen as frequent or as severe.

Dr. Falco: 7:28

So there's something called continuous glucose monitoring. So a lot of people are now wearing glucose monitors, which is a huge improvement, and on their smartphone there's an app, so they're not guessing. If their blood sugar is in range, they know, and they can keep it in range and take their medication when needed, or if their blood sugar is going too low. That can actually be more dangerous than blood sugar going too high for a lot of patients. And they can make. They can have a little orange juice, they can have a little candy just to make sure their sugar is staying in the right zone. So there's a ton of um. There's a ton of things patients you know can do, but they have to come in, be seen, be monitored and everybody has to have open communication to all the doctors who are managing these patients for these patients to have the best outcome.

Jeremy: 8:23

Absolutely, and I think the one message I'd like to give everybody out there is take care of yourself right. Exercise, eat well, get seen frequently, monitor your condition, because it's so much easier to address a lot of these issues before they become major issues.

Dr. Falco: 8:42

Exactly. I mean, like you said, the best thing you could do is move. The best thing you could do is watch what you eat and move your body. I know that these new medications that a lot of patients are using that's going to be approved for obesity in addition to diabetes are work for some patients and they're helping people lose the weight. But the reality is you have to change your lifestyle, because when you're no longer on those medications, how are you going to prevent that from happening again? And so it's hard. We've been conditioned to take a pill and just continue to do what we want to do, but the reality is, with this condition, that's not a great plan. It's a lifestyle and it's changing eating habits and it's moving physically.

Jeremy: 9:31

Yeah, for sure.

Dr. Falco: 9:32

Yeah.

Jeremy: 9:34

Right, very interesting stuff. We could probably talk for hours upon end about this topic, but we'll get into a little bit more with Dr Nguyen, 100%.

Dr. Falco: 9:44

Right Dr.

Jeremy: 9:45

Falco always a pleasure.

Dr. Falco: 9:47

Good to see you.

Jeremy: 9:49

All right. Likewise, and thanks to our listeners for tuning in and we will catch you on the next episode of the Jazzy Eyes Podcast. Everyone, have a great day.

Speaker 1: 10:00

Thank you for listening to the Jazzy Eyes Podcast. For more information, visit jazzyeyescom or contact 954-473-0100.