Dr. Grossman’s Blog

A study published in the New England Journal of Medicine asserts that retinopathy progresses at a slower rate when people with type 2 diabetes adhere to intensive blood sugar control rather than standard blood sugar control. There can be risks associated with intensive blood sugar control regimes that bring glucose levels to near-normal levels including increased the risk of death and severe low blood sugar, so patients should work closely with their doctors when considering a new treatment plan.  Source: LA Times

For more information about diabetic retinopathy and natural treatment options, please visit our website.

Due to hormonal shifts during pregnancy, a woman’s vision can undergo changes during those nine months and can make her eyeglass or contact prescription temporarily uncomfortable.  This is quite normal and vision can be expected to return to its normal state after the birth.

Blurred vision or spots in one’s vision is a cause for concern, however and could indicate high blood pressure that can cause other serious health problems, including detachment of the retina.  Gestational diabetes, a form of diabetes that is generally temporary and lasts for the duration of the pregnancy, can also be marked by blurred vision which can mark unsafe increases in blood sugar.

Sources: CNIB and American Pregnancy Association.

New research announced at Diabetes UK’s Annual Professional Conference links Diabetic retinopathy with poorer memory and diminished brain power in people with Type 2 diabetes. It has yet to be determined whether the advance of cerebral microvascular disease, as indexed by retinopathy, leads to cognitive decline or whether poorer mental acuity makes it more difficult to manage diabetes symptoms and leads to a worsening of the disease. According to Jie Ding from the University of Edinburgh, “It is also possible that a third unidentified factor is causing both diabetic retinopathy and the cognitive changes.” Source: http://www.medicalnewstoday.com/articles/181324.php

For more information on diabetic retinopathy and complementary treatment options, click here.

Researchers at Tennessee’s Oak Ridge National Laboratory have announced that they have developed a machine that allows early diagnosis and treatment of diabetic retinopathy.  The Telemedical Retinal Image Analysis and Diagnosis technology, known as TRIAD is meant to make it possible to screen for the disease at doctor’s offices. (Source: http://www.upi.com/Science_News/2010/05/11/Triad-screens-for-diabetic-retinopathy/UPI-48161273589392/)

Diabetes related blindness is largely preventable if patient and the medical team work together diligently. With timely treatment, 90 percent of those with advanced diabetic retinopathy can be saved from going blind.  Learn more at:http://www.naturaleyecare.com/diseases.asp?d_num=4

A new study now reports that pine bark extract (which contains procyanidins) may extend vision-saving benefits to diabetics with early stage retinopathy by improving retinal blood flow and inducing regression of edema.

It is estimated that between 40 and 50% of Americans diagnosed with diabetes already have some stage of diabetic retinopathy, according to the National Institutes of Health.

Reference: Steigerwalt R, et al. Pycnogenol® improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy. J Ocular Pharmacol Therap 25:537-40, 2009.

Editor’s Note: For an excellent whole food eye formula with Pine Bark Extract, see Dr. Grossman’s Advanced Eye and Vision Support

Researchers in the Department of Ophthalmology and Visual Sciences at the University of Wisconsin have found that risk factors for cardiovascular disease such as smoking and higher body mass index are also risk factors for age-related macular degeneration (AMD).
 
The subjects in this study were 4,288 women age 63 years and older who were participating in the Women’s Health Initiative Sight Examination (WHISE).  Using a standardized questionnaire and examinations, researchers obtained information from the women on cardiovascular disease and its risk factors.  

919 of the women in the study were diagnosed with AMD (determined by standardized grading of fundus photographs).

The results were straightforward:  women who were identified as having four important risk factors for cardiovascular disease were also significantly more likely to have AMD.  These risk factors were:

• smoking
• use of calcium channel blockers
• diabetes, and
• greater body mass index.

Learn more about macular degeneration

Read other studies about macular degeneration research and prevention

SOURCE:  Cardiovascular disease, its risk factors and treatment, and age-related macular degeneration: Women’s Health Initiative Sight Exam ancillary study, Klein, et al, Am J Ophthalmol. 2007 Mar;143(3):473-83. Epub 2007 Jan 10.

A new study shows that early diagnosis and treatment of dry eye syndrome in diabetic patients may help prevent problems such as scarring and perforation of the cornea and secondary bacterial infection.

Scientists at the Yazd Diabetes Research Center evaluated 199 type 2 diabetic patients for dry eye syndrome and other factors.  Of the 199 subjects, 108 patients (54.3%) were found to suffer from dry eye syndrome.

Although dry eye syndrome was more common in older and female patients, this association was not significant.  However, researchers did find a significant association between dry eye syndrome and duration of diabetes.   Researchers also noted that dry eye syndrome was more frequent in diabetic patients with diabetic retinopathy (DR). 

Study authors concluded that dry eye syndrome in diabetic patients may be a contributor for a variety of corneal complications including superficial punctuate keratopathy, trophic ulceration, and persistent epithelial defect.   The authors recommended that examination for dry eye should be an integral part of the assessment of diabetic eye disease.

Learn more about natural relief for dry eyes

Read proactive steps you can take to reduce the effects of diabetes

SOURCE:  Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients, Manaviat, et al, BMC Ophthalmology 2008, 8:10doi:10.1186/1471-2415-8-10.

Homocysteine, an amino acid believed to contribute to heart attack, stroke and dementia, may also play a role in retinal damage and vision loss.  Homocysteine levels rise when folic acid levels drop, a common problem for Americans whose diets are often poor in folate-rich fruits, tomatoes, vegetables and grains.

Dr. Sylvia Smith, cell biologist at Medical College of Georgia (MCG), and Dr. Vadivel Ganapathy, chair of the MCG Department of Biochemistry and Molecular Biology are studying the consequence of slightly elevated homocysteine on the retina under a $1.8 million grant from the National Institutes of Health.  They want to learn the impact of elevated homocysteine levels on the extensive blood vessel and neuronal network of the retina; their preliminary evidence suggests that it isn’t good.

“You don’t have to be a cell biologist to see that there is a problem in this retina. It’s terribly disrupted,” Dr. Smith says, looking at images of a fragmented 10-layer retina exposed to high levels of homocysteine.  A healthy retina is “beautifully” organized, horizontally and vertically, she says.

Folate and vitamin B12 convert homocysteine to methionine, an amino acid essential to protein synthesis.  Dr. Ganapathy notes that people need only about 1 microgram per day of vitamin B12, which comes from microorganisms common in animals’ gastrointestinal tract. Strict vegetarians are typically the only Americans who have problems with B12 deficiency, he says. People need about 400 micrograms of folate daily. Pregnant women as well as those trying to become pregnant need at least double that.

Researchers are studying a mouse model with a slightly elevated homocysteine level that simulates a low-folate diet in humans; a version of the mouse that also has diabetes, which goes along with cardiovascular disease and retinopathy; and a second model of the rare genetic defect that results in extraordinarily high homocysteine levels.  These mice will be put on diets that elevate and lower folate levels, so that resultant homocysteine levels and the impact on the retina can be studied.

Researchers hypothesize that sustained elevation will compromise retinal function and degrade the once well-stratified tissue; in pilot studies, the researchers have shown that diabetes exacerbates this problem.

SOURCE:  Medical College of Georgia, “Impact of elevated homocysteine levels on vision under study,” Oct. 15, 2007.

NATIONAL EYE INSTITUTE (NEI) SURVEY: Most Americans do not know the risks and warning signs of diseases that could cause blindness without timely detection and treatment, according to recent findings of the Survey of Public Knowledge, Attitudes, and Practices Related to Eye Health and Disease, sponsored by the National Eye Institute and the Lions Clubs International Foundation.

More than 3,000 adults were selected randomly to participate in a national telephone survey conducted between October 2005 and January 2006. Seventy-one percent of respondents reported that a loss of their eyesight would rate as a 10 on a scale of 1 to 10 (meaning that it would have the greatest impact on their day-to-day life); however, only eight percent knew that there are no early warning signs of glaucoma.

Fifty-one percent were aware that people with diabetes are at increased risk of developing eye disease, but only 11 percent knew that there are usually no early warning signs of diabetes-associated eye disease. Only 16 percent had ever heard the term “low vision.” Hispanic respondents reported the lowest access to eye health information and knew the least about eye health; they were also the least likely to have their eyes examined among all racial/ethnic groups in the survey.

NEI plans to use the survey results to raise public awareness of eye disease and the importance of early detection and treatment; it will also expand its educational outreach to Hispanics and increase its efforts to educate healthcare providers on how to communicate with patients about preserving and protecting their vision.