Monday, December 29, 2008

What Can You Do About Retinopathy?

If you have been diagnosed with diabetic retinopathy, what can you do?

The standard medical recommendation for diabetic retinopathy is laser coagulation surgery. What most diabetics do not realize until after the procedure is, laser surgery tiny blind spots in the filed of vision of the affected eye. As its name suggests, laser coagulation coagulates the proteins in targeted blood vessels. Those areas of the retina no longer receive light, and there is also reduction in night vision and color perception.

But there is a reliable, non-surgical approach. The very best thing any diabetic can do to reduce the risk of and even reverse retinopathy is to keep blood sugars down. This means, preferably, keeping blood sugars low not just every morning, but after meals, too.

The United Kingdom Prospective Diabetes Study, running from 1977 to 1997, studied 5,200 people with type 2 diabetes. By the standards of the time, diabetics who kept their blood sugars down to an average of 165 mg/dl (corresponding to an HbA1C of about 7) were considered to achieving “tight control.” Just keeping HbA1C, however diabetics managed to do it, reduced the risk of both diabetic changes to the retina and kidney disease by 25 per cent.

And if diabetics also managed to keep their blood pressure down to an average of 144/82, which by current standards is still “high,” the risk of diabetic changes to the retina dropped by 47 per cent. A much better approach to treating diabetic retinopathy is “tight control” of blood sugars. Nothing you can do does more for eye health that controlling both blood sugars and blood pressure.

And nothing in blood sugar control, at least from the standpoint of preserving vision, is more mportant than avoiding corn syrup and other high-fructose sweeteners. Especially during times of emotional stress, adrenalin-related hormones and high levels of fructose in the bloodstream can synergize to induce high blood pressure, high cholesterol, and high triglycerides, all of which are harmful to the eye. Fresh fruit has one advantage over fructose sweeteners: The fructose in fruit is absorbed more slowly because of the fibers and pectin in the fruit. Diabetics who cannot tolerate fructose sweeteners may be able to tolerate small amounts of fruit.

Some supplements also help. The most useful supplements are inexpensive and free of side effects.

The cells of the retina use magnesium to store energy in the form of ATP, and without magnesium, they cannot use glucose. Diabetics of European descent who have retina damage usually are magnesium-deficient, but diabetics of African descent who have retina damage usually are not. This means that not everybody will be helped by taking a magnesium supplement.

Magnesium citrate and magnesium tartrate are best absorbed. Don’t overdose. Magnesium supplements, like the namesake Milk of Magnesia, can cause diarrhea.
Magnesium supplements will not do you any good if you do not get your B vitamins. Vitamin B6 (pyridoxine) is essential for transporting magnesium into the cell.

Vitamin C supports the production of collagen that keeps the blood vessels in the retina in their normal courses. The retina uses vitamin C to make collagen and hang blood vessels in much the same manner as carpenters hang sheet rock on a wall. All diabetics are at risk for vitamin C deficiency even if they get a lot of vitamin C foods in their diets, but just 100 milligrams a day can be enough to slow down retina changes.

The jury is still out on vitamin E. Researchers at the Joslin Diabetes Center and Harvard found that really high doses of vitamin E in the form of alpha-tocopherol, up to 1,800 milligrams a day, could not just prevent retina changes, but even reverse them. The drawback is, taking that much vitamin E can interfere with various medications you take for your circulatory system. Ask your eye doctor before you start a high dose.

OPCs (oligomeric proanthocyanidins) like the ones found in grape seed extract protect collagen from injury from high blood pressure. They stop a collagen-destructive enzyme. Bilberry works in a simlar manner, and ginkgo may help color vision in milder cases.

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