With 77 million people in India living with diabetes, there has been a simultaneous and sharp increase in the prevalence of preventable vision loss related to diabetes, particularly among young people, experts say. Diabetic retinopathy is a chronic and progressive retinal disease that is one of the leading causes of visual impairment in today’s young adult workforce. It is of great concern among children with juvenile diabetes (type 1 diabetes) and especially if they have had diabetes for more than 10 years.
It is estimated that approximately 1.1 million people suffer from retinal disorders in India and, more alarmingly, approximately one in three people living with diabetes has some degree of diabetic retinopathy, a complication of diabetes that affects to the eyes.
“With the increasing incidence of diabetes, it has been estimated that diabetic retinopathy affects one in three people with diabetes and remains the leading cause of blindness in young working-age adults,” Mahipal Sachdev, medical director and president of the Center for Sight Group of Eye Hospital, told IANS.
“Approximately 7 to 10 percent of young diabetics will develop diabetic retinopathy, of which 2 to 4 percent will have vision-threatening sequelae if they do not receive proper treatment.” added Dr. Aditya Sudhalkar, MS Ophthalmology, Vitreoretinal Consulting Surgeon.
The most common form of diabetic retinopathy is diabetic macular edema (AMD), which arises when damaged blood vessels swell and flow into the retinal macula, causing visibility problems in normal vision.
According to Dr. Chaitra Jayadev, Senior Vitreoretinal Consultant, Narayana Nethralaya Eye Institute Karnataka, studies have shown that the prevalence of DME and diabetic retinopathy is higher and more severe in young diabetics with longer-lasting diabetes.
“Diabetes in the very young is a distinct disease entity characterized by a more aggressive presentation and manifestation. An earlier onset of diabetes leads to a longer exposure to insulin resistance and hyperglycemia. This results in increased propensity to develop long-term microvascular and macrovascular processes. complications, “said Dr. Jayadev.
Therefore, detecting diabetes is of the utmost importance, even if one is “young” and has no symptoms. It becomes more crucial if one has risk factors like family history, obesity, sedentary lifestyle, or long-term steroid medications.
Dr. Sudhalkar said that in India there is a general reluctance to attend clinics and nearly 25 percent of young DME patients are late for diagnosis.
“It is important to know that only 11 percent of patients with diabetic retinopathy can reverse the vision-threatening sequelae once they are established. The rest continue to progress even with tight glycemic control,” he noted.
“Retinopathy, unfortunately, is the most neglected complication of diabetes. We see that many patients come to OPD where the eyes have not been examined. Therefore, screening, also known as funduscopy, must be done at the time of diagnosis of type 2 diabetes, in adults and children, five years after diabetes onset, and then annually, “said Dr. Dheeraj Kapoor, HOD, Endocrinology at Artemis, Gurugram.
If diabetes occurs near puberty, funduscopy should be checked for possible retinopathy.
“It is important because the condition has no symptoms in the first few days. And once symptoms appear, such as bleeding in the eye, red vision, sudden vision loss, it is too late,” Kapoor said.
Doctors advised adherence to treatment and maintain a healthy lifestyle to effectively control diabetes and prevent the onset or progression of eye diseases.