Dr. Grossman’s Blog

The American Optometric Association has played an active role in the Centers for Disease Control and Prevention (CDC) Division of Diabetes Translation (DDT) for over ten years.  Eye docs hanging out with diabetes specialists?  Of course.  Diabetic retinopathy, according to the National Institute of Health, affects “4.2 million—28.5%— of people with diabetes ages 40 years or older … and of these, 655,000—4.4% of those with diabetes—had advanced diabetic retinopathy that could lead to severe vision loss.”

W. Lee Ball, O.D., AOA Associate Director for Quality Improvement gave a presentation entitled “Working Together to Manage Diabetes: Development and Testing of a Comprehensive Checklist.”  Of the medical professionals across several fields who responded to a questionnaire regarding the efficacy of the checklist, 74% said they found it useful in a real-world clinical setting.  Source: News from the AOA

A PDF of the presentation (available at this CDC site) recommends that those interested in diabetes prevention, care and treatment visit: www.yourdiabetesinfo.org, an address that links you to a wealth of diabetes information from the National Diabetes Education Program.

For our unique perspective on holistic approaches to dealing with diabetic retinopathy, visit our website.

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Researchers, specifically a group at Harvard’s Joslin Diabetes Center, are understanding the connection between diabetic retinopathy and proteins present in the eyes.  In a 2007 study, scientists describe how they found a group of proteins that they believe are responsible for causing the leakage from blood vessels that marks diabetic retinopathy.  They found that these proteins were also the cause of swelling in the eyes, a discovery that could have an impact on research related to cerebral swelling caused by head injuries and strokes.  Figuring out the role of proteins in this condition opens up new treatment avenues for both eye diseases and brain injuries and conditions.

This study was unique from previous work that focused on rodents because Joslin scientist developed a unique proteomics mass spectroscopy (a high-speed protein analysis technology) that helped to identify protein abnormalities in the vitreous humor of individuals with and without diabetic retinopathy.  These findings have lead to further investigation of the role that proteins within the eyes play in the formation of disease.

This research was published in Nature Medicine.

Source: Joslin Diabetes Center press release

At Natural Eye Care, we know that eye conditions are often related to diseases that affect the entire body.  At a conference last year, Clement Trempe, MD reminded colleagues to consider the role of overall inflammation when diagnosing patients with diabetic retinopathy.

According to Dr. Trempe, “Diabetic retinopathy is not an eye disease, but part of a chronic systemic inflammatory disease process that shares the same risk factors and elevated biomarkers associated with coronary vascular and neurodegenerative diseases such as age-related macular degeneration, glaucoma and Alzheimer’s.”

In line with our way of thinking, Dr. Trempe recommended prevention (see our “Prevention Protocol“). The doctor also emphasized the importance of proper diet, lifestyle, and nutrition (see our self-help recommendations and supplement tips).

Source: PCON Supersite March 1, 2010

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Traditional Chinese Medicine offers invaluable tools for diagnosing and treating conditions of the eyes.

This information is from a chapter of our book, A Comprehensive Manual for Practitioners of Oriental Medicine.

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Blueberries and their European cousins, bilberries, have long been used to regulate blood sugar in people with type 2 diabetes.  Recent studies of mice are convincing researchers of the bilberry’s potential in helping people deal with diabetes.

A study published in Nutrition Journal describes a trial involving the examination of the effect of consuming oat meal drinks that contained bilberries or rosehips on healthy young adults.  Researchers specifically looked at how these drinks influenced individuals’ glycemic indexes and insulin levels.  The drinks with bliberry induced a lower insulin response.  Scientists credit either the bilberry or the oat meal base.  Source: Nutrition Journal (Published: 21 May 2011).

Bilberries are also known to impact eye health in remarkably positive ways. mostly due to their antioxidant properties.  Studies show it has helped patients who suffer from diabetic retinopathy and cataracts, just to name a few conditions.

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Insulin replacement is the main treatment for people with Type 1 diabetes.  A new study seeks to determine how the eyes are not helped through insulin therapies.

In a study of rodents’ retinas that appeared in BMC Medical Genomics, researchers investigated the effect of insulin on the eyes over a 1.5 year period.  This genome-level research showed that though insulin normalizes genes that have been impaired due to diabetes, the insulin therapies are not completely effective when it comes to helping inflammatory processes, microvascular integrity, and neuronal function.  Source: http://www.biomedcentral.com/bmcmedgenomics/

For further information on scientific studies related to diabetic retinopathy, visit our website.

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People who have diabetes often suffer from cataracts as well; in fact, they are more likely than the general population to develop cataracts.  Diabetics considering cataracts surgery need to consider their increased risk factors before they chose to undergo the procedure.

It is very important that patients’ blood sugar is well-controlled before surgery to increase their post-surgical healing ability.  It is especially important that patients’ inflammation levels are monitored and kept as low as possible during and after surgery.

According to Rupert Menapace, MD, of OSN Supersite, “We need atraumatic surgery to minimize the inflammatory response and avoid induction or exacerbation of diabetic retinopathy and macular edema. Even in uneventful cataract surgery, the risk of developing macular edema is high in diabetic patients, up to 10%.”  Macular edema is swelling of the macula, the small area of the retina responsible for central vision, of which the central 5% of the retina is most critical to vision.

Source: “Cataract surgery with comorbidities requires careful surgical management” at http://www.osnsupersite.com.

When a person’s pancreas cannot produce enough insulin to regulate blood sugar levels it becomes possible to develop diabetes.

Scientists at UCLA are working to make other cells in the body act like pancreatic beta cells in a quest to find exciting new therapies for diabetes.  A study published in Developmental Cell describes how researchers may have determined the process that would allow them to convert cells into becoming those essential pancreatic beta cells.

According to study co-author Dr. Anil Bhushan, “Our work shows that beta cells and related endocrine cells can easily be converted into each other.”

The source for this story, Science Blog, says, “It had long been assumed that the identity of cells was ‘locked’ into place and that they could not be switched into other cell types. But recent studies have shown that some types of cells can be coaxed into changing into others — findings that have intensified interest in understanding the mechanisms that maintain beta cell identity.”

Diabetes leads to the related eye condition, diabetic retinopathy, affects over one quarter of diabetes patients over age 40.  Get answers to the most common questions about diabetic retinopathy at our website.

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Diabetic retinopathy is a potentially blinding condition that affects almost 5% of diabetics. Peer reviewed scientific research has found that the following nutritional supplements may help people who are concerned about diabetic retinopathy and diabetes in general.

Chromium: 73% of type I and II diabetics who took chromium supplements reduced their requirement for insulin or oral hypoglycemic agents. Taking chromium and niacin together reduced fasting blood sugar levels and improved glucose tolerance.

Bilberry: 79% of 37 patients with visible diabetic retinal abnormalities improved after taking 160 mg of bilberry extract twice daily, compared to 0% of the placebo control group, and 86% of those with abnormalities of angiography findings showed moderate to considerable improvement.

Ginkgo Biloba: According to the following double blind study, gingko biloba can help improve diabetic retinopathy by improving the flow of blood to the brain and extremities.

For more studies of natural compounds that can help those dealing with diabetic retinopathy, visit our research pages.

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You might be able to avoid an unnecessary medical test if you are over 50: an MRI if you have been diagnosed with isolated ocular motor neuropathies.

New research published in The Archives of Ophthalmology describes how magnetic resonance imaging examinations are warranted for those under 50, who have a history of cancer, have more than one cranial nerve affected, or have a pupil-involving palsy of the third cranial nerve.  In the cases those who are older and are free of these other complications, researchers say that doctors can safely monitor these patients without without neuroimaging, at least at the beginning of treatment.

The authors of this paper came to these conclusions after studying 93 patients with acute isolated mononeuropathies and found that in only one case did an MRI help doctors discover lesions that would have changed the patients’ initial treatment plans. Source: Archives of Opthalmology

Isolated ocular motor neuropathies are most commonly a complication of diabetes.  Learn more about natural approaches to avoiding and coping with diabetes at our website.