Q: I have diabetes and know I need to have a dilated eye examination every year. Is there anything I can do nutritionally to help?

A: The first step would be to maintain a diet rich in fruits and vegetables, avoiding refined carbohydrates like bread, pasta, or “wheat based” foods. Even cooking some vegetables, like carrots, makes them a terrible food for diabetics. The cooking destroys the fiber and allows the natural sugar in the food to enter the bloodstream too quickly, causing an insulin spike and the diabetic “roller coaster”.

A new study has shown that homocysteine, an amino acid found in the blood and previously linked with elevated risk for coronary disease, is also a risk factor for proliferative retinopathy. This is the form of diabetic eye disease that may cause severe vision loss or even blindness. Our office tests all diabetics for homocysteine and counsels on how to reduce it with dietary modification.

Q: My husband has diabetes. Does he need to have his eyes examined?

A: Diabetes is one of the leading causes of blindness and is increasing at an epidemic rate. It is a disease that damages small blood vessels in organ systems throughout the body. Three of the most common problems it causes are nephropathy (kidney disease), peripheral neuropathy (numbness and tingling in the feet and hands) and retinopathy (retinal disease).

In the early stages of diabetic eye disease there are often no symptoms. The only way to determine for sure if the disease is present is to dilate the eyes and perform a thorough retinal examination. Dilation of the eyes is essential. The American Optometric Association advises patients to see their optometric physician at least every year for this exam. Results of your retinal examination will be sent to the primary care provider responsible for treating your diabetes.

Q: I have diabetes, and my mother went blind from diabetic retinopathy. What can I do to make sure it doesn’t happen to me?

A: There are a number of important steps you must take to maximize your chances of retaining good vision. First of all, closely monitor your blood sugar (A1C) with the doctor treating your diabetes. Also maintain consistent yearly eye examinations with your eye doctor. Your may develop the early stages of diabetic eye disease without any symptoms, so annual eye exams are critical. Ask both your diabetes doctor and your eye doctor about the nutritional things you need to do. Most important is to avoid refined carbohydrates (sugar, wheat and grain products, etc) and trans-fats.

Finally, understand that diabetes is a disease of small blood vessels. These vessels become unhealthy and leak. They also are predisposed to form small clots that increase your risk of heart disease, stroke, and diabetic eye disease. Have either of your doctors run blood tests on your homocysteine, C-reactive protein and fibrinogen levels. These factors are not typically run on patients but tell us a great deal about your risk of developing these clots. They are also fairly easy to control without expensive medications.

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