Pediatric Ophthalmology Consultants

Diabetes Mellitus and Diabetic Retinopathy

What is Diabetes Mellitus?

Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood glucose (sugar) levels, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.

There are three main types of Diabetes Mellitus (DM):
Type 1:  This results from not making insulin.  Type 1 diabetics need insulin, either by self-injection or using an insulin pump.
Type 2:  This results from insulin resistance, where cells fail to use insulin properly.  This is sometimes accompanied by reduced insulin secretion. Patients are treated with diet, exercise, oral medication, or a combination.
Type 3: Gestational Diabetes:  Diabetes occurring during pregnancy.

How is Diabetes Mellitus diagnosed?

Diabetes may have symptoms in some people, and no symptoms in others. Generally, Type 1 diabetes presents with increased thirst (polydipsia), frequent urination (polyuria), and increased hunger (polyphagia). Symptoms may develop over weeks to months.  Untreated, this condition may cause a person to lose consciousness and become very ill (diabetic ketoacidosis).  Left untreated, glucose can absorb into the lens of the eye, leading to temporary changes in lens shape and vision changes, including blurred vision.

Types 2 and 3 diabetes may have minimal symptoms. A single, elevated blood glucose measurement can make a diagnosis, or it may require either single or multiple measurements of blood glucose to determine the degree of impairment of glucose metabolism. Your doctor is the person to help you determine if you might have diabetes.

How is Diabetes Mellitus treated?

Diabetes mellitus is a chronic disease for which there is treatment but no known cure.  Treatment is aimed at keeping blood glucose levels as close to normal as possible.  This is achieved with a combination of diet, exercise and insulin or oral medication.  Type 1 diabetics sometimes need to be hospitalized right after they are diagnosed to get their glucose levels down to an acceptable level.

How important is it to control blood sugar levels?

Studies suggest that good control of blood sugar levels decreases the risk of complications from diabetes. In addition to measuring blood glucose levels, glycated hemoglobin (also referred to as hemoglobin A1c) can be measured with a blood test.  Hemoglobin A1c allows for a more accurate picture of the overall blood sugar levels over the preceding 3 months.

What are complications of Diabetes Mellitus?

All forms of diabetes carry the risk of long term complications.  These typically develop 10-20 years after diagnosis, and are related to damage to blood vessels.  Diabetes increases the risk of cardiovascular disease, stroke, and peripheral vascular disease.  Small blood vessel (capillary) damage can affect the eyes, kidneys and nervous system.

How can Diabetes Mellitus affect the eyes?


  1. Blurred vision – If a person’s blood glucose is very high, the glucose can enter the lens within the eye and temporarily cause blurred vision.  This type of blurred vision will usually resolve after the blood glucose level is normalized.

2.Retinopathy – Diabetes may cause blood vessels in the retina (the light sensitive lining of the eye) to become leaky, blocked, or grow abnormally [Figure 1]. Retinopathy is rare before the age of 10 and the risk increases with the length of time a person has diabetes. Treatments such as laser, intraocular injections, or other procedures may be helpful to prevent visual loss or restore sight. The longer a patient has diabetes, the greater chance of developing an eye problem.  All patients with diabetes are at risk for developing retinopathy.  Early retinopathy may have no symptoms, but early treatment is essential to prevent any loss of vision. Annual dilated eye examinations are recommended.

3.Cataract – Occurs at a younger age in diabetic patients

4.Glaucoma- More likely to develop in diabetics than in the general population.

How often should I have my eyes examined if I have Diabetes Mellitus?

A dilated eye examination is recommended at the time of diagnosis. Your doctor will recommend follow-up visits based on your condition. Most patients require yearly dilated eye examinations.


Credits: Journal of American Association for Pediatric Ophthalmology and Strabismus


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