EP #10: The Hidden Threat of Diabetes to Vision with Dr. Nguyen

What if you could prevent needless vision loss? Would you take action? In our enlightening conversation with Dr. Nguyen, we explore the underestimated link between diabetes and vision impairment, particularly focusing on diabetic retinopathy, a leading cause of blindness in working adults. This episode is a wake-up call for everyone, even those who believe they are in perfect health, as we uncover the hidden dangers of this escalating health crisis.

Join us, as Dr. Nguyen expertly unravels the connection between unchecked sugar levels and damage to the small blood vessels in our eyes, a consequence that can lead to severe visual impairment. Discover why regular eye checkups are vital, and how maintaining strict control over your blood sugar levels, along with diet and lifestyle changes, can make a world of difference. If you've ever wondered about the impact of diabetes on vision or if you are curious about the tell-tale symptoms of diabetic retinopathy, then this is the episode for you. Together, let's raise awareness and learn how to protect our vision.

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Episode Transcript

Speaker 1 (00:02):
Welcome to the Jazzy Eyes podcast.
Taking care of your vision withexpert precision.
Here's your host, dr Tui Nguyen.

Jeremy (00:14):
Hello everyone and welcome to the Jazzy Eyes
podcast.
I'm your co-host, jeremy Wolfe,and I'm joined by your host, dr
Nguyen.
Dr Nguyen, always a pleasure.

Dr. Nguyen (00:24):
Nice to see you again.

Jeremy (00:25):
Yes, yes.
So we just finished up a coupleof segments with Dr Falco, and
I love doing podcasts with youguys because I get two different
perspectives usually back toback.
We were talking about Off theHeels of Halloween, which is
actually tomorrow.
November is Diabetes Month andwe were talking a little bit
about diabetes generically andalso a little bit about as it

(00:49):
pertains to the eyes and thevision.
I wanted to see if you couldget into a little bit more about
specifically how diabetes hasan effect on people's vision.

Dr. Nguyen (01:00):
Right.
So yes, november is DiabeticAwareness Month, and it's an
important thing to talk aboutbecause it's a growing epidemic,
pandemic, diabetes, and wereally don't know how it affects
the eyes until it happens allof a sudden, suddenly.
And a lot of people arepre-diabetic, so they don't
really get their eyes examinedevery year until something
happens and boom, they havepre-diabetes and now it's in the

(01:23):
eye.
Diabetes is a microvasculardisease, meaning it affects
small blood vessels, and one ofthe places that we have a lot of
small blood vessels is in theeyes, and so it's actually
diabetic.
Retinopathy is one of theleading causes of blindness in
working-aged adults, and so thesymptoms that could be seen in

(01:46):
diabetic retinopathy is blurredor distorted vision, flashes of
lights and floaters and suddenvision loss, which is a very
scary thing, especially when youthink you're perfectly healthy
and boom, all of a sudden,you've lost your vision for a
couple seconds.

Jeremy (02:03):
Interesting.
So for me, I would never thinkI was at risk of getting
diabetes.
I don't know just so far.
I think, probably with mostpeople and Dr Falco mentioned,
that there's 40, 30, 40 millionpeople that currently have
diabetes in the country and thenanother 8 million undiagnosed

(02:23):
and I think that a lot of peopleare just like me.
They just think, oh, that'ssomething that would never even
happen.
What are some signs to look foror things that might lead you
to believe that it's time to getchecked for that?
Or is that something that getschecked during regular physical
checkups and things like that?

Dr. Nguyen (02:37):
Yeah, so it is checked every year.
We ask you if you're diabeticand if you had any sudden loss
of vision, any blurred vision.
You go to your PCP every year.
Your sugars are normal and allof that stuff.
We dilate you.
It's really important.
That's why we dilate you everysingle year to make sure that
there's no bleeding in the backof the eye, because most people

(02:58):
they don't feel that their eyesare bleeding until you dilate
them and say, oh, you have someblood there.
Are you a pre-diabetic or doyou know anyone in the family?
Because it could be hereditarytoo.

Jeremy (03:10):
But like you said, though, from the vision, from an
optometry standpoint, you won'treally from an examination
standpoint, you won't know thatthis is an issue.
Until it's already an issue,there's nothing you can look at.

Dr. Nguyen (03:22):
You can see it.
There's nothing you can look in.
You can see it in the back ofyour eyes.

Jeremy (03:25):
I think you might be that's something that people
need to go to their generalcheckups at their primary doctor
and get checked for their bloodsugar levels and all that
regularly to make sure there'sno issues.

Dr. Nguyen (03:35):
For diabetic retinopathy.
When you have too much sugar inthe blood, the glucose actually
damages the small blood vessels, making them leaky in the back
of the eyes.
The more sugar that you have inthe blood also means the less
oxygen you have.
So your body tries tocompensate by producing or
growing new blood vessels in theeye.
But these blood vessels areunstable, they're fragile,

(03:58):
they're prone to leaking andbreaking, all of which, when the
eye fails, the blood can loseto loss of vision.

Jeremy (04:07):
Interesting.
So I wanted to ask and maybe wecan do this in another segment
I wanted to ask once you dodetermine there is an issue with
diabetes that's affecting theeyesight, what are some things?
What can someone expect changesto make to treat that condition
?
Do you want to pick that up inanother segment?

Dr. Nguyen (04:27):
So I can explain it right now.
The next one we'll talk aboutsome other issues about diabetes
, and so strict control over theblood sugar is a very important
thing to do, especially whenyou have diabetes.
Having your blood checked A1Cyour blood sugar with the PCP

(04:48):
annually, usually A1C.
We want it to be below 5% indiabetics.
Also, eating a good diet of lowsugars, carbs and all of that
very important, as well asexercise.

Jeremy (05:01):
And just for listeners that didn't hear the previous
segments with Dr Falco, sheexplained this.
Could you briefly recap whatthe A1C is?

Dr. Nguyen (05:09):
A1C is.
It measures how much sugar isin the blood stream within a
three month span.
So every three months they takean average of your blood sugar,
the sugar within your blood,and then they calculate a
percentage called the A1C.

Jeremy (05:27):
Okay, very good, very good.
But in terms of aside fromlifestyle and diet and all that,
when somebody comes in and theystart having their vision
affected by diabetes, is thereanything that needs to be done
medically?
Is it just more frequentcheckups at the eye doctor, or
what can they expect to have todo moving forward?

Dr. Nguyen (05:49):
Yes, frequent checkups for the eye doctor,
absolutely, if it's mild.
If your diabetic retinopathy ismild, we see them use six
months to a year.
If it's a little bit moremoderate to advance, we see you
more frequently within three tosix months and if it gets to the
point where it needs furthertreatment, all of the current
treatments we will send you outto an ophthalmologist to do
either surgery or injections.

(06:11):
All of the current treatmentsaim to either stop or slow the
new blood vessel growth, as wellas reduce any fluids in the
eyes or any swelling, and it canbe done in an ophthalmologist's
office, either via injectionsdirectly into the eye releasing
medication.

Jeremy (06:27):
Yeah, very no, thank you .
Injections in the eye.

Dr. Nguyen (06:34):
Laser, which also is .
It doesn't sound as great Isthat?

Jeremy (06:38):
is it like?
Do you have to when you do aninjection in the eye?
Are you like numbing it up?
Is there pain?

Dr. Nguyen (06:43):
there.

Jeremy (06:43):
I could only imagine what that would feel like.

Dr. Nguyen (06:46):
Yeah, they numb the eye with tetracane until you're
super, super numb and then yeahthey look down and they inject
the top of the eye.

Jeremy (06:54):
I think I would need a valium or something before that.
Just just even being numb justthe idea of looking at a needle
coming into the eye.

Dr. Nguyen (07:04):
Right and they tell you try your best not to move,
don't move your eyes.
Laser doesn't sound asappealing either.
The other option would be laser, where they try to zap the
small blood vessels that areleaking so that it doesn't leak
anymore.

Jeremy (07:18):
But you know, I remember when I got my Lasik surgery
done that was.
I think they did give me avalium before to relax.
That was very it wasn't painful, but it was wildly
uncomfortable in that first theykind of lock your eye down and
then everything goes black andyou see colors and everything,
and then I swear I smelled myeyeball smoking.

Dr. Nguyen (07:37):
Oh my God, when they were doing the laser.

Jeremy (07:38):
I was like this can't be good.

Dr. Nguyen (07:39):
Yeah, yeah, it's very anxiety-intensive.

Jeremy (07:44):
Okay, well, let's end there and we'll get into some
other issues of the eye as itpertains to diabetes.
Okay, All right.
Thanks everyone for tuning inand we will catch you next time.
Take care.