Here is part 2 of our list of questions for Dr. Lewis on the topic of Diabetes:
Q: What treatment options and/or care is available for this condition?
If a patient develops diabetic retinopathy, the severity of the condition will determine the course of care. Patients who develop macular edema, which is swelling in the center of the retina, are referred to a retinal specialist within 1-2 weeks.
Traditionally, macular edema was treated with focal laser treatments. However, recent data has shown that a new class of medication called anti-VEGF is more effective for macular edema than laser therapy alone.
Q: What are the risks and side effects associated with these treatments? What if you don’t proceed with treatment?
Early detection of diabetic retinopathy and treatment with anti-VEGF medications such as Avastin and Lucentis has been shown to be approximately 90% successful in preventing severe vision loss.
Not proceeding with a recommended treatment could lead to quicker and more severe vision loss.
Q: Will a change in a patient’s diet, exercise routine, or medication help at all?
Lifestyle choices play a part in the management of diabetes. Patients that keep blood sugar within normal limits, maintain healthy blood pressure, eat a healthy diet, exercise regularly, and don’t smoke are more likely to avoid diabetic retinopathy or lower the risk of progression.
Q: Can you recommend a vitamin/mineral program for me that might be helpful or are vitamin supplements specific to each patient?
There is limited scientific evidence on the effectiveness of dietary supplements and vitamins in patients with diabetes. Patients should inform their healthcare providers about any supplements that they are currently using or considering.
That being said, there are six supplements commonly used in patients with type 2 diabetes that appear to be generally safe at low to moderate doses: alpha-lipoic acid (ALA), chromium, coenzyme Q10, garlic, magnesium, and omega-3 fatty acids.
Further study is needed to standardize the recommendations involving many of these supplements. Until that time, patients are best off working with their primary care physician to determine a plan to manage their diabetes. This plan should include lifestyle choices, potential medications, and (of course) an annual diabetic eye exam!