EP #10: The Hidden Threat of Diabetes to Vision with Dr. Nguyen

What if you could prevent needless vision loss? Would you take action? In our enlightening conversation with Dr. Nguyen, we explore the underestimated link between diabetes and vision impairment, particularly focusing on diabetic retinopathy, a leading cause of blindness in working adults. This episode is a wake-up call for everyone, even those who believe they are in perfect health, as we uncover the hidden dangers of this escalating health crisis.

Join us, as Dr. Nguyen expertly unravels the connection between unchecked sugar levels and damage to the small blood vessels in our eyes, a consequence that can lead to severe visual impairment. Discover why regular eye checkups are vital, and how maintaining strict control over your blood sugar levels, along with diet and lifestyle changes, can make a world of difference. If you've ever wondered about the impact of diabetes on vision or if you are curious about the tell-tale symptoms of diabetic retinopathy, then this is the episode for you. Together, let's raise awareness and learn how to protect our vision.

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Transcript

Speaker 1: 0:02

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, dr Tui Nguyen.

Jeremy: 0:14

Hello everyone and welcome to the Jazzy Eyes podcast. I'm your co-host, jeremy Wolfe, and I'm joined by your host, dr Nguyen. Dr Nguyen, always a pleasure.

Dr. Nguyen: 0:24

Nice to see you again.

Jeremy: 0:25

Yes, yes. So we just finished up a couple of segments with Dr Falco, and I love doing podcasts with you guys because I get two different perspectives usually back to back. We were talking about Off the Heels of Halloween, which is actually tomorrow. November is Diabetes Month and we were talking a little bit about diabetes generically and also a little bit about as it pertains to the eyes and the vision. I wanted to see if you could get into a little bit more about specifically how diabetes has an effect on people's vision.

Dr. Nguyen: 1:00

Right. So yes, november is Diabetic Awareness Month, and it's an important thing to talk about because it's a growing epidemic, pandemic, diabetes, and we really don't know how it affects the eyes until it happens all of a sudden, suddenly. And a lot of people are pre-diabetic, so they don't really get their eyes examined every year until something happens and boom, they have pre-diabetes and now it's in the eye. Diabetes is a microvascular disease, meaning it affects small blood vessels, and one of the places that we have a lot of small blood vessels is in the eyes, and so it's actually diabetic. Retinopathy is one of the leading causes of blindness in working-aged adults, and so the symptoms that could be seen in diabetic retinopathy is blurred or distorted vision, flashes of lights and floaters and sudden vision loss, which is a very scary thing, especially when you think you're perfectly healthy and boom, all of a sudden, you've lost your vision for a couple seconds.

Jeremy: 2:03

Interesting. So for me, I would never think I was at risk of getting diabetes. I don't know just so far. I think, probably with most people and Dr Falco mentioned, that there's 40, 30, 40 million people that currently have diabetes in the country and then another 8 million undiagnosed and I think that a lot of people are just like me. They just think, oh, that's something that would never even happen. What are some signs to look for or things that might lead you to believe that it's time to get checked for that? Or is that something that gets checked during regular physical checkups and things like that?

Dr. Nguyen: 2:37

Yeah, so it is checked every year. We ask you if you're diabetic and if you had any sudden loss of vision, any blurred vision. You go to your PCP every year. Your sugars are normal and all of that stuff. We dilate you. It's really important. That's why we dilate you every single year to make sure that there's no bleeding in the back of the eye, because most people they don't feel that their eyes are bleeding until you dilate them and say, oh, you have some blood there. Are you a pre-diabetic or do you know anyone in the family? Because it could be hereditary too.

Jeremy: 3:10

But like you said, though, from the vision, from an optometry standpoint, you won't really from an examination standpoint, you won't know that this is an issue. Until it's already an issue, there's nothing you can look at.

Dr. Nguyen: 3:22

You can see it. There's nothing you can look in. You can see it in the back of your eyes.

Jeremy: 3:25

I think you might be that's something that people need to go to their general checkups at their primary doctor and get checked for their blood sugar levels and all that regularly to make sure there's no issues.

Dr. Nguyen: 3:35

For diabetic retinopathy. When you have too much sugar in the blood, the glucose actually damages the small blood vessels, making them leaky in the back of the eyes. The more sugar that you have in the blood also means the less oxygen you have. So your body tries to compensate by producing or growing new blood vessels in the eye. But these blood vessels are unstable, they're fragile, they're prone to leaking and breaking, all of which, when the eye fails, the blood can lose to loss of vision.

Jeremy: 4:07

Interesting. So I wanted to ask and maybe we can do this in another segment I wanted to ask once you do determine there is an issue with diabetes that's affecting the eyesight, what are some things? What can someone expect changes to make to treat that condition? Do you want to pick that up in another segment?

Dr. Nguyen: 4:27

So I can explain it right now. The next one we'll talk about some other issues about diabetes, and so strict control over the blood sugar is a very important thing to do, especially when you have diabetes. Having your blood checked A1C your blood sugar with the PCP annually, usually A1C. We want it to be below 5% in diabetics. Also, eating a good diet of low sugars, carbs and all of that very important, as well as exercise.

Jeremy: 5:01

And just for listeners that didn't hear the previous segments with Dr Falco, she explained this. Could you briefly recap what the A1C is?

Dr. Nguyen: 5:09

A1C is. It measures how much sugar is in the blood stream within a three month span. So every three months they take an average of your blood sugar, the sugar within your blood, and then they calculate a percentage called the A1C.

Jeremy: 5:27

Okay, very good, very good. But in terms of aside from lifestyle and diet and all that, when somebody comes in and they start having their vision affected by diabetes, is there anything that needs to be done medically? Is it just more frequent checkups at the eye doctor, or what can they expect to have to do moving forward?

Dr. Nguyen: 5:49

Yes, frequent checkups for the eye doctor, absolutely, if it's mild. If your diabetic retinopathy is mild, we see them use six months to a year. If it's a little bit more moderate to advance, we see you more frequently within three to six months and if it gets to the point where it needs further treatment, all of the current treatments we will send you out to an ophthalmologist to do either surgery or injections. All of the current treatments aim to either stop or slow the new blood vessel growth, as well as reduce any fluids in the eyes or any swelling, and it can be done in an ophthalmologist's office, either via injections directly into the eye releasing medication.

Jeremy: 6:27

Yeah, very no, thank you. Injections in the eye.

Dr. Nguyen: 6:34

Laser, which also is. It doesn't sound as great Is that?

Jeremy: 6:38

is it like? Do you have to when you do an injection in the eye? Are you like numbing it up? Is there pain?

Dr. Nguyen: 6:43

there.

Jeremy: 6:43

I could only imagine what that would feel like.

Dr. Nguyen: 6:46

Yeah, they numb the eye with tetracane until you're super, super numb and then yeah they look down and they inject the top of the eye.

Jeremy: 6:54

I think I would need a valium or something before that. Just just even being numb just the idea of looking at a needle coming into the eye.

Dr. Nguyen: 7:04

Right and they tell you try your best not to move, don't move your eyes. Laser doesn't sound as appealing either. The other option would be laser, where they try to zap the small blood vessels that are leaking so that it doesn't leak anymore.

Jeremy: 7:18

But you know, I remember when I got my Lasik surgery done that was. I think they did give me a valium before to relax. That was very it wasn't painful, but it was wildly uncomfortable in that first they kind of lock your eye down and then everything goes black and you see colors and everything, and then I swear I smelled my eyeball smoking.

Dr. Nguyen: 7:37

Oh my God, when they were doing the laser.

Jeremy: 7:38

I was like this can't be good.

Dr. Nguyen: 7:39

Yeah, yeah, it's very anxiety-intensive.

Jeremy: 7:44

Okay, well, let's end there and we'll get into some other issues of the eye as it pertains to diabetes. Okay, All right. Thanks everyone for tuning in and we will catch you next time. Take care.