Visual impairment from diabetes on the rise throughout the UAE

With the Emirates currently holding the dubious record of having the world's second highest rate of diabetes, blindness that has developed as a consequence of this condition is increasingly being reported throughout the region.

According to the World Health Organisation, 75% of patients who have had diabetes mellitus for more than 20 years will have some degree of retinopathy; a disorder which affects the eyes and which can lead to visual impairment. The condition correlates with the duration of diabetes and as the region's population experiences ever increasing life expectancy, retinopathy and blindness look set to be problems that will only get worse.

Dr. Zia Ul Hasan, Specialist Endocrinologist at Dubai's Medcare Hospital, explains how diabetes can result in loss of vision. "The eye is a complex organ that is served by a network of blood capillaries," he says.

"High blood sugar levels cause the blood to become much stickier and even form small clots, which over time can damage these tiny vessels and eventually block them. This can result in diabetic retinopathy; a condition that is usually graded in three types," he adds.

"Firstly, there is a fairly benign condition known as background retinopathy, where there is no impairment to vision at all. If this becomes worse, however, it can develop into proliferative retinopathy, where in addition to the clots being formed, the blood vessels in the eye rupture and haemorrhage. This can lead to the retina being pulled out of place and result in complete loss of sight," Dr Ul Hasan continues.

"Another type of eye disorder relating to diabetes is a condition known as maculopathy, where the central vision is affected leading to difficulty in recognising people's faces at a distance, or seeing fine detail such as small print," Dr Ul Hasan points out.

He believes that regular eye examinations are something that should be conducted as a part of a diabetic patient's regular visits to his or her doctor; along with additional check-ups to identify early any signs of the other conditions also related to diabetes. These complications include heart disease and kidney disease, as well as blood vessel problems in the extremities - particularly the feet - which can lead to the loss of limbs.

"Currently, there is no real concerted effort in the UAE to address diabetes and its related complications during a single patient consultation," he says. "I would like to see facilities open for diabetics that offer not only blood sugar and blood pressure testing by physicians and nurses, but also eye testing by optometrists, dietary advice from nutritionists and foot health checks from podiatrists.

"If all brought together under one roof, this system would offer a "one-stop" service and give the diabetic patient the full spectrum of advice and detection of potential problems for his or her condition," he adds.

At the present time, Dr. Ul Hasan recommends regular eye checks for those with diabetes, alongside nutritional advice and frequent foot examinations. "Everyone with diabetes should have at least yearly eye examinations and if detected early enough, many problems can be treated with laser surgery," he advises.

"It's important to point out that laser treatment in this instance will only preserve the sight a person has, not restore it, so it's imperative to ensure that eye testing is performed regularly and not only when sight becomes blurry," he says.

Dr. Ul Hasan also recommends curbs on smoking, since nicotine can make blood even stickier, and to ensure that toenails are cut evenly, with footwear being exactly the right fit," he continues. "It is also essential to get the right advice over a healthy diet to help keep blood sugar levels within the optimum range," he adds.