Diabetic Eye Problems

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood glucose levels.

What eye problems can diabetes cause?

Over time, high blood glucose may damage the blood vessels and lenses in your eyes. This can lead to serious diabetic eye problems which can harm your vision and sometimes cause blindness. Some common diabetic eye problems include:

• Diabetic retinopathy, which is the leading cause of blindness in American adults. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye). The blood vessels may swell and leak fluid into your eye. If it's not treated, it can cause serious problems such as vision loss and retinal detachment, where the retina is pulled away from its normal position at the back of your eye.
• Diabetic macular edema (DME), which happens when blood vessels in the retina leak fluid into the macula (the part of the retina needed for sharp, central vision). This usually develops in people who already have other signs of diabetic retinopathy.
• Glaucoma, a group of eye diseases that can damage the optic nerve (the bundle of nerves that connects the eye to the brain). Glaucoma from diabetes happens when the blood vessels in the front of your eye are damaged, and new blood vessels grow near the iris (the colored part of your eye). The blood vessels block the space where fluid drains from your eye. This causes fluid to build up and pressure to increase inside your eye.
• Cataract, which is the leading cause of blindness worldwide. It happens when the clear lens in the front of your eye becomes cloudy. Cataracts are common as people age. But people with diabetes are more likely to develop cataracts younger and faster than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.

Who is more likely to develop diabetic eye problems?

Anyone with diabetes can develop diabetic eye disease. But your risk of developing it is higher if you have diabetes and:

• Have had diabetes for a long time
• Don't have good control over your high blood glucose or high blood pressure
• Are pregnant
• Have high blood cholesterol
• Smoke tobacco

What are the symptoms of diabetic eye problems?

In the early stages, diabetic eye problems usually don't have any symptoms. That's why regular dilated eye exams are so important, even if you think your eyes are healthy.

You should also watch for sudden changes in your vision that could be signs of an emergency. Call your eye care professional right away if you notice any of these symptoms:

• Many new spots or dark wavy strings floating in your vision (floaters)
• Flashes of light
• A dark shadow over part of your vision, like a curtain
• Vision loss
• Eye pain or redness

Talk with your eye care professional if you have these symptoms, even if they come and go:

• Spots or dark wavy strings floating in your vision
• Blurry or wavy vision
• Vision that changes a lot
• Trouble seeing colors

How are diabetic eye problems diagnosed?

Eye care professionals do dilated eye exams to diagnose eye problems. A dilated eye exam uses eye drops to open your pupils wide so your eye care professional can look for signs of eye problems and treat them before they harm your vision. They will also test your vision and measure the pressure in your eyes.

What are the treatments for diabetic eye problems?

Treatment for diabetic eye problems depends on the problem and how serious it is. Some of the treatments include:

• Lasers to stop blood vessels from leaking
• Injections (shots) in the eye to stop new, leaky blood vessels from growing
• Surgery to remove blood and scar tissue or replace a cloudy lens
• Eye drops to lower fluid pressure in the eye

But these treatments aren't cures. Eye problems can come back. That's why your best defense against serious vision loss is to take control of your diabetes and get regular eye exams. It's also important to keep your blood pressure and cholesterol in a healthy range.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Heart Disease

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood sugar levels.

What is diabetic heart disease?

Diabetic heart disease is a term for heart disease in people who have diabetes. If you have diabetes, you are much more likely to develop heart disease or have a stroke than people who don't have diabetes. And you may start having these problems at a younger age.

Over time, the effects of high blood sugar from diabetes can include damage to the blood vessels and nerves in your heart. This damage increases your chance of developing heart diseases, including:

• Coronary artery disease (CAD). It happens slowly as a sticky material called plaque builds up in the arteries that supply your heart muscle with blood.
• Heart failure. With this condition, your heart can't pump enough oxygen-rich blood to meet the needs of your body.
• Cardiomyopathy. This is a group of diseases in which the heart muscle may become thick or stiff.

Who is more likely to develop diabetic heart disease?

Diabetes puts you at serious risk for heart disease. It also makes you more likely to develop other conditions that raise your risk even more, including:

• High blood pressure
• High blood levels of LDL "bad" cholesterol
• High triglycerides (a type of fat in your blood) with low blood levels of HDL "good" cholesterol

Your risk for heart disease is also higher if you

• Are male
• Smoke
• Have obesity
• Have too much belly fat around your waist, even though you're at a healthy weight:
  • For men, that's a waist more than 40 inches
  • For women, that's a waist more than 35 inches
• Have a family history of heart disease
• Have chronic kidney disease

What are the symptoms of diabetic heart disease?

In the early stages, heart disease usually doesn't have any symptoms. But if your heart disease worsens, you can have symptoms. Your symptoms will depend on the type of heart disease you have. They might include:

• Shortness of breath
• Fatigue
• Dizziness or fainting
• Arrhythmia (problem with the rate or rhythm of your heartbeat)
• Swollen feet and ankles
• Chest pain

It's important to know that people with diabetes may not feel chest pain. That's because diabetes can damage the nerves in your heart. If you have any symptoms that could be heart disease, talk with your health care provider.

How is diabetic heart disease diagnosed?

To find out if you have diabetic heart disease, your provider will:

• Ask about your medical history, including your symptoms and other health conditions you may have
• Ask about your family history, to find out if you have relatives who have or had heart disease
• Do a physical exam
• Likely run some tests to help understand your personal risk for heart disease, including:
  • Blood tests to check your cholesterol, triglycerides, and blood sugar levels
  • A blood-pressure check
  • Heart tests, if needed

Depending on your risk level, your provider may send you to a cardiologist (a doctor who specializes in heart diseases) for care. If you do have heart disease, treatment will depend on the type of heart disease you have.

How can I prevent diabetic heart disease?

You may be able to prevent heart disease or keep it from getting worse by working with your provider to:

• Control your blood sugar levels
• Manage other conditions you may have that can raise your risk for heart disease
• Take any medicines your provider prescribed
• Make heart-healthy habits part of your daily life
• Follow a healthy eating plan for diabetes

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Drug Reactions

Most of the time, medicines make our lives better. They reduce aches and pains, fight infections, and control problems such as high blood pressure or diabetes. But medicines can also cause unwanted reactions, such as drug interactions, side effects, and allergies.

What is a drug interaction?

A drug interaction is a change in the way a drug acts in the body when taken with certain other drugs, foods, or supplements or when taken while you have certain medical conditions. Examples include:

• Two drugs, such as aspirin and blood thinners
• Drugs and food, such as statins and grapefruit
• Drugs and supplements, such as gingko and blood thinners
• Drugs and medical conditions, such as aspirin and peptic ulcers

Interactions could cause a drug to be more or less effective, cause side effects, or change the way one or both drugs work.

What are side effects?

Side effects are unwanted, usually unpleasant, effects caused by medicines. Most are mild, such as a stomachache, dry mouth, or drowsiness, and go away after you stop taking the medicine. Others can be more serious. Sometimes a drug can interact with a disease that you have and cause a side effect. For example, if you have a heart condition, certain decongestants can cause you to have a rapid heartbeat.

What are drug allergies?

Drug allergies are another type of reaction. They can range from mild to life-threatening. Skin reactions, such as hives and rashes, are the most common type. Anaphylaxis, a serious allergic reaction, is less common.

How can I stay safe when taking medicines?

When you start a new prescription or over-the-counter medicine, make sure you understand how to take it correctly. Know which other medicines, foods, and supplements you need to avoid. Always talk to your health care provider or pharmacist if you have questions about your medicines.

Drugs and Young People

What is drug use?

Drug use, or misuse, includes:

• Using illegal substances, such as
  • Anabolic steroids
  • Club drugs
  • Cocaine
  • Heroin
  • Inhalants
  • Marijuana
  • Methamphetamines
• Misusing prescription medicines, including opioids. This means taking the medicines in a different way than the health care provider prescribed. This includes
• Taking a medicine that was prescribed for someone else
• Taking a larger dose than you are supposed to
• Using the medicine in a different way than you are supposed to. For example, instead of swallowing your tablets, you might crush and then snort or inject them.
• Using the medicine for another purpose, such as getting high
• Misusing over-the-counter medicines, including using them for another purpose and using them in a different way than you are supposed to.

Why are drugs especially dangerous for young people?

Young people's brains are growing and developing until they are their mid-20's. This is especially true of the prefrontal cortex, which is used to make decisions. Taking drugs when young can interfere with developmental processes occurring in the brain. It can also affect their decision-making. They may be more likely to do risky things, such as unsafe sex and dangerous driving.

The earlier young people start using drugs, the greater their chances of continuing to use them and become addicted later in life.Taking drugs when you are young can contribute to the development of adult health problems, such as heart disease, high blood pressure, and sleep disorders.

Which drugs most commonly used by young people?

The drugs that are most commonly used by young people are alcohol, tobacco, and marijuana. Recently, more young people have started vaping tobacco and marijuana. There is still a lot we don't know about the dangers of vaping. Some people have unexpectedly gotten very ill or have even died after vaping. Because of this, young people should stay away from vaping.

Why do young people take drugs?

There are many different reasons why a young person may take drugs, including:

• To fit in. Young people may do drugs because they want to be accepted by friends or peers who are doing drugs.
• To feel good. Abused drugs can produce feelings of pleasure.
• To feel better. Some young people suffer from depression, anxiety, stress-related disorders, and physical pain. They may do drugs to try to get some relief.
• To do better in academics or sports. Some young people may take stimulants for studying or anabolic steroids to improve their athletic performance.
• To experiment. Young people often want to try new experiences, especially ones that they think are thrilling or daring.

Which young people are at risk for drug use?

Different factors may raise a young person's risk for drug use, including:

• Stressful early life experiences, such child abuse, child sexual abuse, and other forms of trauma
• Genetics
• Prenatal exposure to alcohol or other drugs
• Lack of parental supervision or monitoring
• Having peers and/or friends who use drugs

What are the signs that a young person has a drug problem?

• Changing friends a lot
• Spending a lot of time alone
• Losing interest in favorite things
• Not taking care of themselves - for example, not taking showers, changing clothes, or brushing their teeth
• Being really tired and sad
• Eating more or eating less than usual
• Being very energetic, talking fast, or saying things that don't make sense
• Being in a bad mood
• Quickly changing between feeling bad and feeling good
• Missing important appointments
• Having problems at school - missing class, getting bad grades
• Having problems in personal or family relationships
• Lying and stealing
• Memory lapses, poor concentration, lack of coordination, slurred speech, etc.

Can drug use in young people be prevented?

Drug use and addiction are preventable. Prevention programs involving families, schools, communities, and the media may prevent or reduce drug use and addiction. These programs include education and outreach to help people understand the risks of drug use.

You can help prevent your children from using drugs through:

• Good communication with your children
• Encouragement, so your children can build confidence and a strong sense of self. It also helps parents promote cooperation and reduce conflict.
• Teaching your children problem-solving skills
• Setting limits, to teach your children self-control and responsibility, provide safe boundaries, and show them that you care
• Supervision, which helps parents recognize developing problems, promote safety, and stay involved
• Knowing your children's friends

NIH: National Institute on Drug Abuse

Dry Mouth

What is saliva?

Saliva, or spit, is made by your salivary glands. It helps keep you and your mouth healthy. For example:

• It moistens and breaks down the foods you eat, which makes it easier for you to chew and swallow.
• It washes away small food pieces from your teeth and gums, which helps fight against tooth decay.
• It contains minerals such as calcium and phosphate, which can also help fight tooth decay.
• It contains antibodies that can fight against infections of the mouth and throat. Antibodies are proteins that your immune system makes to fight foreign substances such as viruses and bacteria.

What is dry mouth?

Having dry mouth, also called xerostomia, means that you don't have enough saliva to keep your mouth wet. Everyone has a dry mouth once in a while, like when you are nervous or stressed. But if you have a dry mouth all or most of the time, it can be uncomfortable. It can make chewing, swallowing, and even talking difficult. It also raises your risk for tooth decay or infections in the mouth.

What causes dry mouth?

There are many possible causes of dry mouth, including:

• Side effects of certain medicines, such as some medicines for high blood pressure, depression, and bladder-control issues
• Diseases such as Sjogren's syndrome, HIV, salivary gland disorders, and diabetes
• Radiation therapy, which can damage your salivary glands if they are exposed to radiation during the treatment
• Chemotherapy, which can make your saliva thicker and cause your mouth to feel dry
• Nerve damage, when it involves the nerves that tell salivary glands to make saliva
• Breathing through your mouth
• Use of alcohol, tobacco, or other substances

What are the symptoms of dry mouth?

The symptoms of dry mouth may include:

• A sticky, dry feeling in your mouth
• Trouble chewing, swallowing, tasting, or speaking
• A burning feeling in your mouth
• A dry feeling in your throat
• Cracked lips
• A dry, rough tongue
• Mouth sores
• An infection in your mouth
• Bad breath

How is the cause of dry mouth diagnosed?

If you have dry mouth, it's important to find out the cause. To do that, your health care provider or dentist will review your medical history, examine your mouth, and ask about any medicines you take. They may also suggest blood tests or a test that measures how much saliva you produce.

What are the treatments for dry mouth?

Treatment for dry mouth depends on the cause. For example, if a medicine is causing dry mouth, your provider or dentist may suggest adjusting the dosage or switching medicines. In some cases, they might give you artificial saliva or a medicine to help your salivary glands work better.

There are also several things you can do to help relieve your symptoms:

• Drink plenty of water
• Avoid drinks with caffeine, which can dry out your mouth
• Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow
• Avoid spicy or salty foods because they can cause pain if your mouth is dry
• Avoid alcohol and tobacco
• Using a humidifier at night
• Use a mouthwash made for dry mouth

Since dry mouth can raise your risk of tooth decay, it's important to brush and floss your teeth regularly and see your dentist at least twice a year.

NIH: National Institute of Dental and Craniofacial Research