Diabetes, Fasting and Eye Health

In these days when we enter the month of Ramadan, it is useful to remember the effects of fasting on diabetic patients.

Diabetes, or diabetes as it is known among the people, has been determined by the United Nations as a health problem that must be tackled at the first degree all over the world, and the World Health Organization has determined the disease as a new epidemic disease.

The prevalence of diabetes in our country is above the world average. With 2 million 400 thousand latent diabetes patients, a total of 5 million people have diabetes or are at risk of diabetes. According to the Turkish Diabetes Epidemiology Study, the rate of diabetes over the age of 20 is 7.2% and 32% of these patients are unaware that they have diabetes.

Diabetes is a condition that develops as a result of the body’s inability to obtain energy from blood sugar and leads to bankruptcy of the pancreatic gland, which secretes insulin hormone (Type II diabetes). In type I diabetes, the body cannot produce insulin since childhood due to immune disorder.

In these patients, with the effect of high sugar in the blood, disorders in organs, especially kidneys, eyes and nerves, begin. 20-30 percent of patients diagnosed with type 2 diabetes have eye disorders, 10-20 percent kidney disorders, 30-40 percent hypertension, 50-80 percent blood lipid disorders and 80-90 percent moderate Complications of vascular damage occur.
In addition, due to the difficulty in accepting the disease, mental and social problems follow.

In the early stages of diabetes, a frequent and balanced diet is sufficient to control the fluctuations in blood sugar and thus insulin secretion. When the disease progresses and the use of medication becomes mandatory, the diet still maintains its importance at the same rate.

As it is known, skipping meals, staying hungry for a long time, or even eating less than necessary can cause “hypoglycemia” by lowering blood sugar excessively. About 1/3 of patients with diabetes fast despite the warnings of doctors, and a significant portion of them consume more sweets during Ramadan due to traditional reasons and excessive low blood sugar. Since most patients with new diabetes, who are treated with pills, have not yet encountered the severe side effects of diabetes and are not sufficiently aware, they do not mind breaking the rules.

So, how does hunger and thirst for more than 10 hours affect diabetic patients? Among fasting patients, hypoglycemia (extreme decrease in blood sugar) attack was found in 47% of insulin users. Hypoglycemia is a dangerous condition that causes symptoms such as sweating, shivering, dizziness, palpitations, numbness in the lips and hands, headache, attention disorder, fatigue, feeling of hunger, blurred vision, distraction, restlessness and nervousness.

In addition, in patients with hyperthyroidism and using insulin, hypoglycemia attacks double when fasting.

In an international meeting held in Morocco in 1995, it was reported that while controlled fasting with an acceptable risk is allowed in patients with type II diabetes, those who should not fast are as follows: Patients with type I diabetes, patients with irregular blood sugar, as well as those with a degenerative disease, pregnant women and the elderly. . In addition, education and monitoring should be carefully pursued.

As a result, it is essential for diabetic patients to be under the control of a doctor in case of fasting. In addition, healthy individuals who have not yet been diagnosed with diabetes should have their fasting blood sugar measured, as well as fasting blood sugar, before starting fasting.

Let’s take a look at the effects of sugar on the eyes:

Irregular ups and downs in blood sugar affect the organs negatively. The most important organ that it affects in the eye is the RETINA (the layer of the eye’s visual cells). The disease in the retina begins as punctate hemorrhages and micro-bubbles in the vessel walls and continues with vascular occlusions, leaks, neovascularization and sudden intraocular hemorrhages, tears. We know that 80-90% of diabetic patients develop this disease in the retina within 10 years at the latest. If we remember how high diabetes is in our country, we will understand the risk of vision loss. Diabetes, which is the leading cause of blindness in the world, is one of the diseases that threaten vision in our country.

For this reason, it is of great importance for patients diagnosed with diabetes to have a retinal examination every 6 months to 1 year, even if they do not have any complaints. It is impossible for the patient to detect this disease, which starts as point disorders, early. However, they are seen on retinal examination. When diabetic retinal disease (diabetic retinopathy) is seen, angiography (medicated film of the eye vessels) is performed to determine whether laser treatment is required and if necessary, how many sessions are required. Today, argon laser therapy is a method used all over the world. In addition, vision loss can be prevented by administering new drugs that reduce edema and vascularity in patients with fluid accumulation in the visual center due to vascular disorders in diabetes. Patients with retinopathy should continue to be followed every 3 months after the end of treatment. Because diabetes continues and this means that there will be new disorders in the healthy areas of the eye. In summary, diabetic retinopathy is a disease that can result in permanent blindness if continuous follow-up and treatment is not performed and treatment is delayed. In cases that are delayed, the eye is tried to be saved with vitreo-retinal surgery.

Cataracts and glaucoma are also more common in diabetics than in other people. As the increase in blood sugar causes cataracts, fluctuations in sugar may temporarily impair the patient’s vision. For this reason, while giving glasses to diabetics, attention should be paid to the normal level of sugar. High sugar causes the eye to shift to myopia by increasing the camber of the eye. Cataract surgery should not be rushed, the patient should be well informed that retinopathy progresses rapidly after cataract surgery and therefore retinal controls are even more important. The vast majority of these patients experience a short period of clear vision after the removal of the cataract, and when they think that their vision has progressed as a result of the progression of retinopathy, they apply to other centers in desperation, thinking that they have had an unsuccessful operation.

High blood sugar also causes itchy eyes. These can be relieved with simple eye drops. As it is known, there are no symptoms such as itching-watering in retinal diseases.

Eye pressure (glaucoma) is also important in diabetics. These patients also have problems such as blood pressure and cholesterol, and the blood pressure medications they use disrupt the nutrition of the optic nerve even if the eye pressure does not rise much, making the patient more susceptible to vision loss due to glaucoma (normal tension glaucoma).

It is known that during pregnancy, retinopathy due to diabetes progresses more rapidly due to hormonal reasons. Therefore, retinal examination should be repeated frequently in these patients.

Diabetics, especially those using insulin, should stay away from sugar or sweets during the holidays. Even people without health problems should not consume too much sugar or sweets. Sugar causes aging in the body. Sugar has an anti-inflammatory effect in the body. This means non-microbial inflammation. It threatens many organs in the body, especially the eyes, kidneys and nerves, and prepares the ground for degenerative diseases. Diabetic patients may experience problems such as dizziness, mental confusion, palpitations, and weakness in a short time as a result of a sudden rise in blood sugar and then a decrease (hypoglycemia) if they consume sweets or sugar during the holiday, and then they may face blurred vision.

In order to prevent this situation, let’s not give credit to the sweets and candies we love, even if it is a holiday, and let’s offer fruits that are not too sweet to our friends who we know have diabetes. Diabetics should also stay away from artificial sweeteners and prepared foods. Hidden sugars under different names in a wide variety of ready-to-eat foods also pose a danger to diabetics.

The more conscious people with diabetes act about their diet and lifestyle, the longer they can lead a quality life. Even if it means giving up our favorite flavors.

 

If we can learn to live with diabetes, we can make room for better pursuits in our lives.

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