hello everyone today we are talking
about diabetic retinopathy which is
diabetic eye disease today we will touch
base the symptoms the causes the risk
factors diagnosis treatment and
complications so let's get started guys
i am dr ahmed erik i'm an
endocrinologist and a diabetes
specialist i treat patients with
diabetes every day and i ask one single
question every day have you seen your
eye doctor extremely important a lot of
people end up going blind and the most
common reason for blindness is diabetic
retinopathy so we're going to go over
all these today and at the end of the
video i'm going to give you a bonus tip
so stay tuned and before we get started
please hit the subscribe button and
let's go so guys before we jump to the
topic i want to encourage you to take
the quiz in the description below to win
a chapter from my diabetes book let's
move on
so i want to emphasize why understanding
this horrible complication of diabetes
is so important because think about this
two out of five of every diabetic has
some sort of diabetic eye disease that
includes everyone controlled and
uncontrolled if you're not uncontrolled
the chances of diabetic retinopathy is
90 percent that's huge now if you
already have underlying diabetic
retinopathy and if you control your
diabetes and your blood sugars you can
reduce your risk by up to 54
now if you do not even have retinopathy
at all but you just got diagnosed with
diabetes you can reduce your risk of
diabetic retinopathy or diabetic eye
disease up to 75 so let's talk about
symptoms the most common symptoms of
diabetic retinopathy is blurry vision
that comes and goes it gets better and
gets blurry again you may have a change
in the perception of the collar so the
colors may fade away you may end up not
seeing very well at night so it's called
poor night vision you may end up
developing some floaters or dark spots
in your eye that kind of increases in
number gradually so what are the real
serious symptoms that you have to go see
doctor today immediately is if you see a
curtain coming down over your eyes that
would be i think anyone can tell is not
good if you start seeing flashing of
lights all over your eyes if you start
seeing a tunnel vision where the
peripheral vision is totally lost so you
cannot really see your sides well these
are almost emergencies that you have to
hit the emergency room or hit the
doctors the eye doctor's office today so
why does diabetic retinopathy develop to
begin with right so how come the high
blood sugar caused the diabetic
retinopathy well number one when you
have high blood sugars and we discussed
about this before when your body cannot
utilize the sugar that sugar has to go
somewhere right and then we call this
alternative pathways like sorbitol
pathway protein kinase c hexazolamine
pathway
etc now what happens with these pathways
is body does not really know what to do
with a blood sugar and trying to get rid
of it it's like you know you have a
manager that knows what to do and then
manager calls sick and you just assign
one of the employees who has no idea
what to do but he has to be there
because he needed a manager and then you
know that person does something troll
tries to do something but ends up
messing a lot of things up right that's
typically what happens when an
inexperienced person takes on the job so
same thing when your body is trying to
process the glucose in an alternative
pathway in different pathways you end up
creating a lot of cytokines especially
inflammatory cytokines and growth
markers so these are the things that
lead to what we call endothelial damage
which is the blood vessel wall it's
called endothelium when there is a
damage in your endothelium what happens
is you start leaking fluid and sometimes
the blood itself the wall of the
arteries especially when they get thin
they start ballooning and we call them
aneurysms so the aneurysms typically end
up bursting eventually as well so that
brings us to staging so how do we really
stage diabetic retinopathy we divide
into two so one is non-proliferative one
is proliferative so what does the
proliferative the the blockage of those
arteries induces the growth factors for
other new vessels to develop and the new
vessels are not as good or strong now
this formation of that new blood vessels
are called proliferation so that's why
we call them first non-proliferative
which means you know this is the initial
stages of diabetic retinopathy where
you're not really getting these new weak
vessels yet or the arteries yet but you
start seeing certain features in the eye
now versus proliferative is more
advanced stage where you start seeing
these new weak arteries so the first
stage of non-proliferative retinopathy
is the mild stage and that's pretty easy
right then in the mild stage you know
the doctors can see the weakening of the
blood vessels there's some aneurysms
maybe there's some leakage but typically
there's no symptoms at this stage now
when it becomes moderate the larger
areas of these blood vessels become more
visible leaky et cetera and then
symptoms of pleural vision may develop
at that stage now it is severe that is
the beginning of the proliferation where
your body is attempting to start making
the new arteries in your retina now of
course the next stage will be the
proliferative diabetic orthonopathy
where you see a bunch of the bleedings
the exudates fatty and fluidy oxidation
your retina and then the proliferation
which is the new vessels coming up and
then they actually start bleeding even
more because they're weaker and that's
not a total mess at this stage the
doctors intervene and move you to the
treatment stage so what are the risk
factors actually for
diabetic or therapy well number one is
your genes so some people are
unfortunately more prone to have
diabetic complications and that is very
difficult to estimate who's going to be
prone to
until they get it so don't just assume
or just try to being positive and say oh
i think i probably have good genes well
there may be too late by the time you
figure out that you're you do not so i
would suggest definitely try to do
everything you can do to get your blood
sugars under control
now unfortunately if you're
african-american hispanic or native
american the chances of diabetic
retinopathy is more if you're a smoker
definitely the diabetic orthopaedic risk
is more because the smoking also weaken
your arteries when you're pregnant you
have to be
watching that out more carefully it
really gets worse during pregnancy so if
you already have rapid retinopathy and
you're pregnant you better see your
doctor way more often than normal and if
you have high blood pressure and high
cholesterol and people ignore that
people get hung up on your blood sugars
but i tell them all the time you know
your blood pressure is as important your
cholesterol is important because again
this is all about the blood vessels and
your blood vessels are going to be
damaged with the high blood pressure and
high cholesterol as well studies
indicate that actually if you control
your blood pressure in addition to your
blood sugar remember we talked about up
to 75 risk reduction with controlling
the blood sugars you can get another 35
40 risk reduction on top of that if you
control your blood pressure as well now
remember we have how to control blood
pressure naturally videos you can find
it right here or you can just search on
youtube and watch the video it's
extremely important for you to
understand the blood pressure control
now what are other conditions that are
actually not necessarily diabetic
retinopathy or bleeding or anything like
that but you still associate with
diabetes well number one cataract
cataract is very common but it's super
common in diabetes what else glaucoma
they're gonna be like how the hell
glaucoma is associated with the diabetes
well the glaucoma is all about your eyes
draining the fluid in your eye when your
eye is not able to drain the water then
then you end up having a lot of pressure
in your eye which is not good and it
starts pushing on the nerves and causes
damage now when you have proliferation
in the areas where your eyes are trying
to drain that water it creates the
blockages and that also leads to
glaucoma as well which leads to if
untreated especially to blindness the
macular edema is also common it happens
to non-diabetics as well but since the
edema happens from the leakage of the
damaged blood vessels you are more
likely to have macular edema which
definitely is a very high risk disease
for blindness now what do you do to
diagnose that big retinopathy well see
your eye doctor so typically we
recommend seeing the eye doctor once a
year and if everything is okay your
diabetes is under perfect control it's
okay to stretch it up to two every two
years but if you already have some
retinopathy going on at least every year
and in some cases doctors may want to
see you every six or even three months
for your eye examinations so what are
the treatment options well your eye
doctor will do a few things most
commonly nowadays they use something
called vgef which is a egf inhibitors
they are basically injecting a substance
to your eye to inhibit the proliferation
of the new vessels we talked about they
will sometimes do a laser
photocoagulation which is basically
burning the the leakage points and
making sure that your blood vessels are
not leaking anymore sometimes they will
do a pen photocoagulation which
basically does decrease the
proliferation in your entire retina and
finally they sometimes will do something
called retrectomy and that is a
procedure where they go in and remove
all the blood from your uterus area
nutritious area is a liquidy watery area
behind your eye and sometimes acute
bleeding happens and you may have a
temporary vision loss and that will
definitely need intervention another
scary thing that happens to
some diabetics is retinal detachment so
that's basically because of the scar
tissue and remember when your body is
trying to heal something it creates scar
and when there is a scar in your retina
it starts pulling the retina off of your
wall of your eye and when that happens
that's definitely the reason for
blindness so they can reattach it but
you may not be always very lucky so
don't wait until you have retinol
detachment so i hope guys this helped
you so far if it did please subscribe
and remember to take the quiz at the end
of this video and remember do not wait
until the complications develop we have
a lot of antioxidants in the foods or in
the supplements that can help you but
the most importantly you will have to
understand the importance of diabetes
control there's so many ways to do it
the diet the exercise the supplements
the medications whatever you have to do
you have to get these blood sugars under
control today to prevent the
complications later so i hope guys this
helped again subscribe like share and we
will see you in the next video
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