Duration of Diabetes and Retinopathy

[belyro]

Well, in light of my recent "proliferative retinopathy" diagnosis, shortly after my 25-year D-anniversary, I've been getting curious about the incidence of retinopathy once one gets "up there" in D-years like me.

I really don't know what to expect with this poll, and if it turns out that LOTS of D-veterans have retinopathy, I hope it doesn't scare any D-newbies. That's not my intent. This is just something I really want to know as part of my processing of this news.

[Mick]

I was disappointed there was no spot for "Diabetes for 40+ years and NO retinopathy"! According to my eye doctor, my eyes have no "signs of diabetes" whatsoever, now in my 42nd year of it.

Michael

[belyro]

I was disappointed there was no spot for "Diabetes for 40+ years and NO retinopathy"! According to my eye doctor, my eyes have no "signs of diabetes" whatsoever, now in my 42nd year of it.

Michael

Wow! Congrats Michael! I'd by lying if I said I wasn't jealous.

[SueM]

42 years + and no signs of Retinopathy.

[notme]

21 years and no sign of retinopathy. A spot or two to watch, but that is it. I will always worry.

[BriOnH]

I have around 7 'spots' total in both eyes - 31 years of diabetes.

I had a detached retina that needed to be lasered from my fighting days, not D related.

I was diagnosed with Macular Edema by 3 physicians 'eye balling it'. On the tests I made them do there was no physical evidence that I had MA. The tests where:

Florecent Angiogram -- peeing after this one is weird. Your urine turns BRIGHT carrot orange. It's pretty trippy after staring at lights most of the day. Its a non painful, and very easy test imo.

Optos Retina Scan - best thing since sliced bread for the retinas imo. I really hope you can get this done Beth.

I can't remember the name of the last test, but basically what they do is measure with a laser the 'swelling' that is occuring with the macula - it came back perfect.

My kidneys are what I worry about more :(.

Isn't diabetes just so fun? If the sex, drugs, and rock and roll wont kill me, there is always the sugar.

[xMenace]

You didn't include a surgery option. :captain:

[duck]

I have around 7 'spots' total in both eyes - 31 years of diabetes.

I had a detached retina that needed to be lasered from my fighting days, not D related.

I was diagnosed with Macular Edema by 3 physicians 'eye balling it'. On the tests I made them do there was no physical evidence that I had MA. The tests where:

Florecent Angiogram -- peeing after this one is weird. Your urine turns BRIGHT carrot orange. It's pretty trippy after staring at lights most of the day. Its a non painful, and very easy test imo.

Optos Retina Scan - best thing since sliced bread for the retinas imo. I really hope you can get this done Beth.

I can't remember the name of the last test, but basically what they do is measure with a laser the 'swelling' that is occuring with the macula - it came back perfect.

My kidneys are what I worry about more :(.

Isn't diabetes just so fun? If the sex, drugs, and rock and roll wont kill me, there is always the sugar.


Brother, don't let the sugar kill you. Work harder on letting the sex, drugs or rock and roll kill you.

[Dewey]

This is just my personal opinion, but if we think about it, there are so many factors involved in the "why" or "why not" of who may or may not get complications.

Some people have different complications after 25+ years. Some have had the beginnings of retinopathy, and have been able to reverse the effects....others have dealt with different complications (i.e. dental issues, etc.). Again, there are so many variables.

Things like self-care & BG control, genes, how the individual body reacts to situations (which varies greatly from person to person) can all play a role in whether or not we wind up with complications.

I've had Type I for 25 years, and in the past, have dealt with the beginnings of background retinopathy. I was able to reverse the effects by tightening the reigns on my control. However, this doesn't ring true for everyone. I will say that that is why I'm so harsh on myself over A1Cs of 6.1 (or 6.3). While those numbers may be great for some, others (like myself) may experience more high levels to achieve those results. Likewise, while others may think a person has to have a hypo a day (or many trips to the ER) to get A1Cs of 5.8 or 5.6, others won't have such problems & will still be able to achieve those results.

The bottom line is that like most things, even complications are a very individual thing, and I don't know if we can truly gauge complications by the amount of time we've had Diabetes. Please don't take what I'm saying wrong, I know this hasn't been easy for you, Beth, and I understand you're trying to make sense of it all. :(

[mark-TN]

Diabetes 32+ years. I have mild nonproliferative diabetic retinopathy in the form of 1 or 2 microaneursysms at my last check up(this has slowly been improving over the past couple of years). The iScan report (http://www.inoveon.com/iscore_report.html) from this past November showed no macular edema and a retinopathy level of 20(click on iScan link, then on the 20, to see explanation). I feel extremely fortunate.

Mark

[belyro]

You didn't include a surgery option. :captain:

I was only allowed 10 options. ;)

[Mich]

I wish there were more options. I agree that there are many factors.

I went 27 years with none, then got to 44 years before it became proliferative. After laser, all was well for a year and a half until I got my pump, then the laser scar tissue formed, causing bleeds and pulled retina tissue. Not sure if it was getting the pump or the fact that 18 months had passed. There is some research to support sudden tighter control being associated with onset of other complications.

Now I've followed up with treatment for detached retina which required three (count 'em THREE) vitrectomies. Three different detachments on the same retina. My optho, bless his heart will not give up on me.

I still feel lucky. Otherwise healthy, Fairly good sight in my other eye. One other note: My diabetic GG Grandmother was pretty much blind from hers. A genetic component perhaps?


Mich
Going on 48 years type 1

[gettingby]

My optho said he wouldn't know I was diabetic by looking at my eyes. Almost 24 years and no signs of retinopathy. I do have floaters from time to time but were told that anyone can get them, not just diabetics.

[xMenace]

I wish there were more options. I agree that there are many factors.

I went 27 years with none, then got to 44 years before it became proliferative. After laser, all was well for a year and a half until I got my pump, then the laser scar tissue formed, causing bleeds and pulled retina tissue. Not sure if it was getting the pump or the fact that 18 months had passed. There is some research to support sudden tighter control being associated with onset of other complications.

Now I've followed up with treatment for detached retina which required three (count 'em THREE) vitrectomies. Three different detachments on the same retina. My optho, bless his heart will not give up on me.

I still feel lucky. Otherwise healthy, Fairly good sight in my other eye. One other note: My diabetic GG Grandmother was pretty much blind from hers. A genetic component perhaps?


Mich
Going on 48 years type 1


Wow, hang in there.

I didn't think laser scar tissue led to detachement. Are you sure you never had bleeding?

[Mich]

Yes, I had bleeding in that eye. Perhaps I misunderstood. I thought he said both the bleeding and the laser scarring led to the detachment. I go see him again the 18th and will ask him to explain it again, then share it here.

[xMenace]

Cumulative makes more sense. Was the tear in the periphery?

[BriOnH]

Brother, don't let the sugar kill you. Work harder on letting the sex, drugs or rock and roll kill you.

Sorry to go off topic, but

AMEN!

[Lizzy]

43 years here and no sign of any eye damage! I feel so very fortunate.

[cheryl]

Nothing yet but one broken blood vessel i dunno what that means but the eye dr wasn't concerned cause he said it was clearing up or it looked like it was already healing when he found it.....

I am 16 yrs with D myself had lots of dental issue's though....loads of them.

[HiImDan]

Diabetes for nearly 30 years (first three untreated, thanks dr. hostetler) I've had around 20 laser treatments in my right eye, 5 in my left plus a fame four experiment that made matters worse:). I'm legally blind.

[Gordonm]

33 years and no problems. My eye Dr. said there are no signs of any damage. I feel lucky about this as the first 15 years were not the best of control. We just did not have the resources or products we have now.

[jjames]

Then of course there are those that have < 10 years diabetes experience and have already been lasered. :( And who said being young and stupid was fun?

But - I've read something that was rather interesting that Jedi had posted in another thread. He said something along the lines that if one had to choose, that it would be better to run consistently high rather than consistently swaying from low-to-high-to-low and so on. It's strange that after four years of running an A1C of 13+ that I didn't have any problems except for some slight neuropathy. Since starting back on a plan - that's when I noticed my eyes went down hill. Perhaps it caught up with or maybe it was better to run consistently high rather than swing from 60-180 and back down. Who knows?

[belyro]

It's strange that after four years of running an A1C of 13+ that I didn't have any problems except for some slight neuropathy. Since starting back on a plan - that's when I noticed my eyes went down hill. Perhaps it caught up with or maybe it was better to run consistently high rather than swing from 60-180 and back down. Who knows?

This is my case too. I didn't have an A1C of 13+....it was typically in the 8s, but it was only when I started getting my diabetes under control and bring my A1C down that I started to get more hemmoraging, and now the proliferative. *big sigh*

[xMenace]

This is my case too. I didn't have an A1C of 13+....it was typically in the 8s, but it was only when I started getting my diabetes under control and bring my A1C down that I started to get more hemmoraging, and now the proliferative. *big sigh*

The Grunter, my optho, says there's no medical basis for this theory. They were going to bleed anyway.

[belyro]

The Grunter, my optho, says there's no medical basis for this theory. They were going to bleed anyway.

But then why does it happen so often?

[cheryl]

OMG, me too, i don't have what you consider damage as far as I know with my eyes, but when I went back in Nov. and had the broken vessel this was after I was gaining back control and not living in the 300's-400's anymore......I will see what goes on in August i have to go back then to make sure there is no new damage.......could be a link there...

Cheryl

[KickStart101]

After a coma and carrying my Son through
pregnancy, I had laser for PR on my left eye
only, 22 yrs. after being dxd. No others needed.

I had my Ophtho appt. on Tues. and he's
Happy, I'm Happy. :D My eyes look Great
and he doesn't want to see me 'til June/08.
Unless I need him sooner, of course, which I
won't(kow). I'm 45+ yrs. since diagnosis.

[Mich]

Here are some references from the search using the above words and Google. I believe most of these studies cite the improved circulation in the retina and the increase in VEGF (endothelial growth factor) that are a result of tighter control.

In this 1985 paper:
Dah-Jorgensen Dahl-Jorgensen K, et al. . Rapid Tightening of blood glucose control leads to transient deterioration of retinopathy in insulin dependent diabetes mellitus: The Oslo Study Br Med J 1985. 290: 811-815.

At this site: Proliferative Retinopathy (http://medweb.bham.ac.uk/easdec/proliferative.html) (DiabeticRetinopathy.org.uk)

(quotes from the above)

A sudden improvement in control will lead to a temporary rapid increase in progression of retinopathy: laser may be needed.

Good control is important in the longer term, that is after about 2 years, when people who control their diabetes well will be better off. See

A temporary increase in retinopathy is most common when starting insulin for the first time, especially if the diabetes is very badly controlled when you start the insulin.

And iIn this article: Why some cases of retinopathy worsen when diabetic control improves -- Chantelau and Kohner 315 (7116): 1105 -- BMJ (http://www.bmj.com/cgi/content/full/315/7116/1105)

Mich