Despite our well-intentioned New Year’s resolutions, sugar is very much still a weakness for many in 2024. If you’re already diabetic and controlling your sugar intake as part of your daily routine, the start of the new year is an ideal time to lay out a plan with your doctor for maintaining and improving your health and wellness while also managing diabetes. This is especially true of current patients experiencing symptoms of Diabetic Macular Edema (DME), or retinal thickening in the center of the macula.
DME is currently the most common cause of vision loss in patients with either type 1 or 2 diabetes. These patients may develop symptoms that include blurry or double vision, increased difficulty distinguishing colors, and seeing dark strings or “floaters."
If you develop DME it means you already have diabetic retinopathy, a growth of abnormal blood cells in the retina of the eye. Both conditions are a result of poorly controlled blood sugar. However, vision loss may be prevented with early and persistent treatment. While diabetes can be reversed in most cases, diabetic retinopathy is not fully reversible.
Mismanaged diabetic retinopathy may result from high blood pressure, high cholesterol, gestational diabetes if you’re pregnant, and frequent tobacco use. Given the alarming statistic that diabetes affects the Black community at a rate 60 percent higher than white peers, it’s more important than ever to keep the community healthy and vital.
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Any diabetes discussion with your doctor should revolve around reaching an ideal blood sugar target, especially if you’re over the age of 35. The National Institute of Health (NIH) has suggested blood sugar levels before a meal should be at 80 to 130 milligrams per deciliter (mg/dL). Your blood sugar levels should be below 180 mg/dL two hours after beginning a meal.
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The NIH also recommends a list of foods to help regulate and hopefully reverse diabetes enough to keep the DME more easily manageable. These include fruits, vegetables, whole grains (rice, oats, barley, and wheat), protein, and dairy.
The best sources of protein are leaner meats, eggs, skinless poultry, fish, beans, and tofu. Heart-healthy fats found in avocado, salmon and nuts are also highly recommended.
When grilling or frying foods, room-temperature canola, avocado, or olive oils are much more beneficial for your long-term health than cooking with butter.
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For those venturing toward a vegan diet, kale has been found to contain levels of protein comparable to red meat, and has similar or higher levels of calcium compared to most sources of dairy.
As always, curbing the intake of fried foods, sweets, and sugary beverages is strongly suggested. Your doctor may have ideas for how to structure a meal plan, including portion size and carbohydrate counting. A course of medical nutrition therapy may also be beneficial, depending on your needs and what your medical insurance can cover.
The more severe cases of DME require more invasive treatments, such as anti-VEGF injections or steroid injections in or near the eye, laser treatments, eye drops, or eye surgery.
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VEGF, or vascular endothelial growth factor, refers to the body’s overproduction of a protein that causes swelling in the retina. Anti-VEGF drugs such as Avastin and Lucentis are administered by monthly injection and include a numbing process before injection.
Depending on the severity of the DME, the patient may need the injections for a few months, or indefinitely. Steroid injections or eye drops are another invasive treatment option, but using these does come with an increased risk of developing cataracts or glaucoma.
Wherever you might be in your current journey with DME, diet and lifestyle changes seem the most effective approach toward curbing the condition, or at least minimizing its adverse effects. Regular eye exams are key to monitoring how the condition is progressing, and dictating your next steps. Staying mindful and connected to your health and wellness will keep you living a fuller, healthier life.
