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Re: [IPk] Retinopathy (was Re: Chilren with pumps)

Dear Carmel, just to add to Pat's words of support, it is probably
impossible to have NO changes at the back of the eye after 25 years or more
of diabetes. Retinopathy can be as small as a tiny swelling in a blood
vessel in a very unimportant part of the retina, and this may be another
reason why the doctor wasn't terribly impressed by it. It may not need any
further treatment for many years, and retinopathy is now so treatable that
once detected it is unlikely to EVER threaten your sight.

While it is true that improving control sometimes triggers a moderate
progression in retinopathy, better control is still the BEST way to stop it
in its tracks. Control of other risk factors, particularly blood pressure
and micro-albumin in the urine, also help. Some research is now suggesting
we should use a tablet called an ACE inhibitor to protect from progressive
retinopathy. This makes some sense, as these BP-lowering meds certainly
protect against progression of the other "small vessel" complication, kidney
trouble. Like Pat, I've had a touch of laser after 25 yrs T1, and my sight
is the better for it. I'm supposed to be taking an ACE inhibitor, but I
can't bring myself to take tablets. Injections, pumps, and lancets no
problem, but a tablet.......!

We all carry fears about diabetes complications that derive from the
experiences of people 5-10 years ago. Things are a whole lot better now. I
wouldn't worry about anyone with detected retinal problems, what worries me
is the people who don't get their eyes checked at all, or have a cursory
examination by someone who is not truly qualified.

My advice, is be looked at EVERY year (from diagnosis in T2, or after 5
years of T1) with drops to dilate the pupils, by an eye specialist, a
retinal camera or a diabetes specialist. This is a standard I expect will be
adopted throughout Europe. If it isn't happening, insist on it or contact
the DFI or Diabetes UK.

We all fear loss of sight more than anything. For me, this is the most
important reason to keep working hard, as we are all doing. Everything will
work out fine Carmel. Basically what I'm trying to suggest is, we need more
determination and less fear.

Tony O'Sullivan
email @ redacted

----- Original Message -----
From: "Pat Reynolds" <email @ redacted>
To: <email @ redacted>
Sent: Wednesday, September 12, 2001 9:49 PM
Subject: [IPk] Retinopathy (was Re: Chilren with pumps)

> Dear Carmel,
> Did you recently improve your control?  Improved control is (ironically
> enough) a trigger for diabetic retinopathy (mine developed when I was
> able to start measuring my blood glucose, and hence improved my
> control).  It's one reason why everyone starting the pump should see an
> eye specialist soon after.
> My eyes don't seem to have been affected by the improved control from
> the pump.
> Have you been given laser treatment yet?  It's not nice ... you have to
> stare at a flashing - which sounds ok, but is wearying, and after you
> feel bruised.  In my case, it's been very effective - and while there
> have been some downsides (loss of quality of colour vision, not being
> able to see both near and far with one pair of glasses, and poor night
> vision), I still see well enough to drive.
> As to the attitude of the doctors ... well, I guess they don't realise
> the impact of what they say.
> Best wishes,
> Pat
> dm 30+, 508 5months+, not wanting to file her heap of photocopying!)
> --
> Pat Reynolds
> email @ redacted
>    "It might look a bit messy now, but just you come back in 500 years
>    (T. Pratchett)
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