Diabetic Retinopathy is the 3rd leading cause of blindness in India. It is the leading cause of blindness in the newly detected cases among the adult blind in the age group of 20 to 74 years. Each year 12 to 24000 people loose their eye sight because of Diabetic Retinopathy. According to WESDR international study 25% Type I diabetic patients suffer from Diabetic Retinopathy after 5 years and 80% suffer after 15 years. Up to 21 to 25% of the newly diagnosed Type 2 diabetic patients have some degree of diabetic Retinopathy when just tested.

Other factors affecting diabetic retinopathy are hypertension, cholesterol, smoking and chronic alcohol.

Diabetes not only affects retina in the form of retinopathy and could cause corneal ulcers, increased intra ocular pressure, a condition called glaucoma or early development of cataract, bleeding into vitreous cavity and paralysis of extra ocular muscles to develop diplopia or double vision.

In the retina the development of diabetic retinopathy is due to damage to the minute blood vessels, the condition called micro angiopathy. This causes leakage of blood into retinal tissue which causes deficient oxygen supply. This stimulate new blood vessels to develop. These blood vessels are minute, friable and hence bleeding occurs into the retina and vitreous resulting in total loss of Eye sight.

A through periodical examination of the eyes and Retina in particular is important. This incude Refraction, intraocular pressure measurement, slit lamp bio-microscopic examination, fundus examination and fundus flourescein Angiography where indicated

As the old saying goes Prevention is better than cure. To prevent Diabetic Retinopathy is diabetic should have a intensive glucose control, keep blood pressure under control, cholesterol and anemia managed well and above all have a regular periodical eye check-up

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Diabetes mellitus is assuming pandemic proportions in its incidence, especially in South Indians. If statistics are to be quoted, by 2030, 30% of our population will become diabetic.The only way we can modify that figure is adapting to change in lifestyle in a scientific manner.

Today, with better group of drugs and newer insulins, the life expectancy of a diabetic patient is par with any other individual. Diabetic patients can also lead normal healthy lives if they are careful in their habits and their approach to complications of the disease, and have the willingness to seek medical advice without delay.

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Diabetes mellitus is on the increase worldwide. The core principles of diabetes management include medication, patient-education and lifestyle modulation. In many cases,
especially in the first few years after diabetes has been detected, patient education and lifestyle modulation can help the individual to achieve good glycemic control without resorting to medication. On the one hand, favorable lifestyle changes can help delay introduction of medication in the early stages of diabetes. On the other hand, lifestyle modulation facilitates the peak performance of insulin and oral hypoglycemic agents, so as to achieve optimal glycemic control with minimal medication. Lifestyle modulation is thus an essential component of diabetes management.

Diet: Since food is the entry-point for sugar into the body, a well-planned dietary regimen is essential for good glycemic control. In addition to restricting intake of foods with high glycemic index, we also need to ensure adequate nutrition of the diabetic patient. The diet must be planned according to the tastes and dietary practices of the individual. Caloric restriction must be accompanied by intake of plenty of high-fibre foods such as fresh leafy vegetables to add bulk to food and derive the benefits of dietary fibre. Diabetics must learn to eat small, frequent meals in order to avoid post-prandial rise in blood sugar and also avoid hypoglycemia. Detailed information regarding diet can be found in the “Diet and Nutrition” section of our website.

Exercise: Regular aerobic exercise helps lower blood sugar. It also reduces insulin resistance and facilitates optimal performance of insulin and oral hypoglycemic agents. Walking, jogging, swimming, cycling, and dancing are examples of aerobic exercices. The diabetic patient needs around 45 minutes of exercise per day, at least five days a week. People who walk long distances as part of their jobs, or perform other types of strenuous physical exertion daily, do not need further exercise. However, sedentary individuals must be advised to start and sustain a regular exercise regimen that is sufficient to maintain ideal body weight and ensure good glycemic control
on a daily basis.

Lifestyle modulation is a complex topic.This short article is only intended to introduce this subject. At Malabar Diabetes Foundation, we give much importance to patienteducation and lifestyle modulation as adjuncts to regular medication. Our own observations indicate that patients have shown marked improvement in daily glycemic control after attending one of our daily classes on lifestyle aspects of diabetes care. Various studies conducted all over the world have proved that lifestyle changes are significant in achieving good glycemic control.Lifestyle modulation is hence widely acknowledged to be a cornerstone of diabetes management.