Diabetes and diabetic eye screening

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Diabetes is a condition where your blood sugar level is higher than normal. Diabetic retinopathy occurs when diabetes damages the small blood vessels in the retina of the eye.

Understanding diabetes

A healthy pancreas gland produces the hormone  insulin. The body uses this insulin for transferring glucose into cells to create energy.

With diabetes, the body's lack of insulin means it can't use the glucose and it tries to find other energy sources. This leaves diabetes sufferers with high levels of glucose in their blood.

There are two main types of diabetes, type 1 and type 2.

Type 1

This type is caused by the body producing little or no insulin.

It usually develops in:

  • children
  • young people

Type 2

This type (formerly called non-insulin-dependent diabetes) is caused by the body not producing enough insulin and not being able to use it effectively.

It is usually linked to genetics and lifestyle and may have few symptoms in its early stages.

It tends to affect:

  • adults over 40
  • overweight and inactive people
  • some young people 
  • people of Asian origin

Other types of diabetes

  • gestational diabetes - which affects some pregnant women
  • secondary diabetes - which is caused by other conditions or by some medicines such as steroids

Recognising the symptoms

Typical symptoms of type 1 diabetes include:

  • feeling very thirsty
  • passing urine more often than usual, particularly at night
  • feeling very tired
  • weight loss and loss of muscle bulk

Type 2 symptoms may not always be so clear and may take longer to develop, but if you're at risk your glucose level can be measured by a blood sample. In random glucose tests, blood samples are taken twice, at random times. There's also a fasting glucose test where your level is measured after an overnight fast.

If the diagnosis isn't clear from these tests, you may have a glucose tolerance test in which you give a blood sample, have a glucose drink, then two hours later give another sample, and the results are analysed.

Reducing your risk of getting diabetes

  • if you smoke, stop
  • have your blood pressure checked - and treated if it is high
  • if you're overweight or obese, lose weight
  • find out your cholesterol level - if it's high, reduce it by eating a low-fat diet
  • be aware of the symptoms and risk factors (such as family history) of diabetes
  • reduce your intake of refined sugar, such as biscuits and cakes

Controlling diabetes

You can't cure diabetes, but you can control it.

Type 1 diabetes is always treated with insulin injections (these are also used in some Type 2 cases). This increases the insulin in your body and brings the blood glucose level down. Your doctor or practice nurse will show you how to inject yourself.

Type 2 is treated with a combination of a healthy diet and regular exercise and, if necessary, tablets or insulin injections. You'll also need to be careful about your calorie intake and watch your weight.

Living with diabetes

Diabetes doesn't have to interfere with your life if you:

  • take care of yourself,  by exercising, eating well, not drinking too much alcohol or smoking
  • have regular checks-ups with your doctor - every three to six months or annual diabetes check-ups at your local clinic; including annual tests for long-term complications such as eye or kidney disease
  • monitor your blood glucose levels, if needed - you can do this easily at home with a small blood-glucose meter and depending on the reading, possibly adjust your diet, the amount of exercise you do, or your medication

Checking your eyes and feet

Diabetes can damage your nerves, particularly those in your feet. Sometimes this will lead to numbness or burning or tingling in the feet. Check your feet regularly for cuts, ulcers and blisters. These can become infected if left untreated.

Diabetes can also cause the blood vessels at the back of the eyes to leak (its known as diabetic retinopathy). But the more you can control your blood sugar levels over the years, the less chance you have of developing serious eye problems. Make sure you have an annual eye test with a specialist so that any potential serious eye problems can be caught early on and treated.

Diabetic eye screening

Screening for diabetic retinopathy can detect changes in the retina at an early stage before you are aware of them.

Importance of attending screening

These small blood vessels in the retina can become blocked or leaky, affecting how the retina works. Sometimes abnormal ‘new vessels’ grow which are weak and can bleed easily. In the early stages, these changes will not normally affect your sight. If left untreated, the retinopathy may get worse and your vision may be affected.

It is important to have your eyes screened and that you go to all screening appointments. If detected in time, treatment is very effective at preventing loss of vision in most people.

For more information on diabetic retinopathy screening, go to:

The information on this page was provided by the Department of Health.

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