Is it true that most children diagnosed with diabetes at a very early age lose their vision by the time they get to puberty?

No. That might have been the case many years ago, but, fortunately, blindness due to diabetes is becoming less common now. Whilst the total number of people with diabetes continues to grow, the percentage who go blind are getting less and less each year.

There are several reasons for this. First, we are getting better at examining eyes in people with diabetes regularly. This means that we can detect those who have any sight-threatening changes early and treat them. You have probably heard of laser treatment for diabetes. With modern lasers and the experience that we now have in treating the disease, we can reduce the risk of blindness, even in those who have sight-threatening disease, considerably. The earlier that sight-threatening disease is detected and treated, the more likely that we can prevent progression of the disease.

Even more importantly, there have been several recent clinical studies that have shown us that tight control of diabetes can make the risk of developing sight-threatening retinopathy much less likely. Furthermore, if someone already has sight-threatening retinopathy, tightening of the control can often prevent progression and, in some cases, can make things better. In older patients with diabetes, controlling blood pressure and cholesterol also helps.

So, the most important thing for a young person who has diabetes is to keep the diabetes tightly controlled. The best measure of how well controlled your sugar levels are is a test called the HbA1c. This measures the average sugar levels in the blood and gives an idea of how things have been for 2-3 months. The HbA1c is, therefore, a much better test than the normal blood sugar tests which only tell you what the level of sugar is at the time of the test. Studies have shown that the best HbA1c level, in order to prevent problems, is between 6-8%. So, the next time you see your diabetologists, ask them what your HbA1c is. This will tell you how well controlled your sugar has been, over several months. If you do find that your HbA1c is higher than 8%, you must not try to improve things yourself, without supervision. Sudden changes of blood sugar levels can sometimes make retinopathy worse.

Finally, it is important that you have your eyes looked at regularly, especially after you get to about 12 years of age. Taking photographs of the retina is the best way to do this. This means that the doctor has a permanent record of what your retina looked like at each visit and, in future, they can compare any changes with older photos. These days retinal photos are taken with special digital cameras: so if you change doctors, move to another city etc. you can have the photos on disc or CD and carry them with you.

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