You've got to stay on top of it with regular checkups, not just by a
regular ophthalmologist, but preferably by a retinal specialist.

Retinopathy is probably the single most common complication of
diabetes. If you have diabetes long enough, it's almost certain that
you'll get it.

My retinopathy appeared some 20 years after I was diagnosed with Type
1 diabetes.

But the good news is that if it's caught early, there are very
effective treatments. I had "panretinal photocoagulation," which
involved some 2,000 small laser burns in the back of each eye.

Going through this was no picnic, and one result was that I lost much
of my peripheral vision. But the retinopathy was stopped dead in its
tracks, and my vision has been stable now for 20 years. No further
treatments were required.

I agree with your "this totally sucks" comment on diabetes in general.
Every once in a while I think we all come down with a generalized case of
"diabetes-itis."  The main symptoms are being mad at fate, and tired of
paying attention.  You feel like you're doing everything right, everything
you're told, and you already know that this ain't easy, it takes real work,
and it's pretty much not only 24X7 but for however long forever lasts.  Then
you go to the docs (GPs and Endos both make this mistake) and there's a
progression and they look at you like somehow you cheated, when the fact of
the matter is that you did MORE than they suggested, educated yourself, paid
attention, and so forth.  This is where meticulous record keeping comes in:
the first time it happened (my overweight GP accused me of not following the
program) I had LOST 12 pounds (I didn't need to) and was miserable.  I
handed him not only my testing logbook, I handed the son of a gun my food
logs.  He sat back on his heels right quick like.  The motto here is :If
you're doing the right stuff, don't be afraid to inform them, be pleasant,
but set them back on their heels.  I suspect they do see a lot of people who
are non-compliant and they just ASSUME most are not, when a lot of us are.

This is a progressive disease:   people do a lot of things absolutely right,
and it still progresses, which makes you feel like a big fat failure (or a
dieting skinny one asking yourself why you didn't eat more Twinkies when you
had the chance, since it wouldn't have made a d*mned bit of difference)  Now
that's counterproductive:  makes me want to head straight for the chocolate
SO

I try to focus on the "I can slow it down and make the disease really have
to WORK to get me" aspects of its management.  It sounds like you are doing
a lot of things right.  There's a lot of unknowns about it, and for those of
us who don't fit squarely into either T1 (I was 50 when diagnosed) or T2 (I
was normal weight, physically active, low cholesterol, low BP, good diet,
yada dada dada...see comment about the Twinkies above) holes.  You'll read
about it all in this newsgroup, which has some really caring, knowledgeable,
helpful and caring people (along with a few stinkers, but that would be a
topic for another discussion.)

------------------------------------------------------------------------------
Judy G.
Keep an open mind, and keep on trying, even if you don't get GREAT results,
because NOT trying always gives  disastrous results.
Remove the obvious to email me.

Keep those bgs down and get that A1c below 6 and keep it there.  Watch
your carbs and follow jennifer's advice to detirmine what you can eat
without big spikes.  Hold yourself to hight standard for low bgs adn you
MAY(no promises here) not need laser down the road.  Your retinopathy may
well not progress fruther is yu take charge.  

Well, tht's my pep talk for today.

Wendy

Yeah : (    {{{{{{{{{{Ricavito}}}}}}}}}

A Quentin keeper - courtesy of Alan and Annette : )

Nicky.

---------------------------
From: "Alan S" <loralweightandcarbs@optusnet.com.au>
Subject: Re: My Eyes and a Warning
Date: 04 June 2005 11:16

On Sat, 04 Jun 2005 21:00:15 +1200, Quentin Grady
<quentin@paradise,net,nz> wrote:

Howdy Quentin

I always liked this one pardner. I suspect this may be the
one you're after. Thank goodness you don't use x-no archive.

Originally you wrote it to:

"G'day G'day Fester, Annette et al,
(see http://tinyurl.com/7kl8x Nov 26 2003)

Avoiding macular degeneration is multifactorial.
It pays to tackle the issue as many ways as possible.
Not many team sports are won with a single defender.

1.  Control blood glucose tightly.  The eyes don't have
insulin receptors so don't require insulin to transfer
glucose into the eyes in the way muscles do.  What this
means if blood glucose is high then glucose rushes into the
eye just as the sea rushes into inlets when the tide is
high.

2.  Glucose in the eye can be converted to sorbitol by an
enzyme called aldose reductase.  Picture sorbitol like the
bloke with a black hat in a Western.  When the bloke on the
horse with a black hat rides into town something bad is
going to happen.  The sombre music tells you so.  You can't
be sure of which plot the Western will follow ...
there are only a few but something real bad is going to
happen when the black hatted guy rides in to the theme of
"Sorbitol, Sorbitol, Sorbitol who you gunna bowl?"

Fortunately is Westerns worthy of the name there are blokes
who wear white hats, aldose reductase inhibitors, Ari for
short.   All good Westerns have a bit of tear jerking but it
better be brief so we can get on an enjoy the action.  In
the shoot out between Sorbitol and Ari, the tear jerking
element is onion.  Onion is an excellent source of
biologically available Quercetin. (Any resemblance to my own
name is entirely coincidental.)  Quercetin is an excellent
antioxidant great for curing hay fever ... told you this was
a tear jerker.  It doesn't matter if you fry up the onion in
a pan on a camp fire, Quercetin can take it just don't pour
it down the drain.  Whatever, Quercetin saves the day and
stops aldose reductase from converting glucose to Sorbitol
and your eyes are saved from numerous fates worse than
death.

3.  If you can't stop Sorbitol from riding around shooting
up things the next best thing is having him corralled in a
box canyon.  Enter stage left to great applause ... Taurine.
Taurine keeps sorbitol boxed up with osmotic pressure.
Taurine is an amino acid found in fish especially shellfish
and fish hearts etc, meat that hasn't been over cooked.  Eat
some green lipped mussels or sardines.  Steak that gallops
onto your plate has more taurine than one grilled to death.

4.  OK, Westerns were black and white but the audience
demanded more. They wanted colour.  Now at first the colours
weren't very good. People got a bit confused with their
colours and thought beta carotene from carrots were good for
eyes.  Bugs Bunny got a lot of good press when the real hero
was Olive Oil who no doubt nagged Popeye just a little bit
to eat his spinach.  Spinach looks green but it hides some
good yellow stuff called lutein (yellow) that protects the
peripheral regions of the eye from the ravages of blue and
ultraviolet light. Lutein does a wonderful job in providing
sunglasses INSIDE the eye. Young people need the sunglasses
effect of lutein because their eyes are clear. Older people
need the antioxidant effects of lutein because ... they are
old.  The clock of ages gallops for T2 diabetics who don't
take care.  Wait don't send money.  There is more.  Spinach
has a special bonus offer ... orange centres.  The central
foveal regions of the eyes NEED ORANGE ... a very special
orange.  Nah, not beta carotene.  Beta carotene is a
wannabe.  THE orange is zeaxanthin.  Now it is kind of
special. While lutein is in most things green or yellow
zeaxanthin is less widely distributed.  Spinach is often a
good source though it varies. So is open leaf cabbage ie
collards.

Orange capsicums are the ultimate source.  Persimmons are
excellent. In some countries the likely sources are going to
be the green culinary herbs eg dill, coriander, parsley. The
Mexicans have it nailed with marigold petals.

4.  Some general antioxidants help; bilberries, blue
berries, Vit E, astaxanthin (the pink stuff in salmon and
prawns.)  Lowering oxidative stress is smart thinking.

BUT remember there are no substitutes for lutein and
zeaxanthin for the sunscreen effects. Other bioflavanoids
will not do.

Carrots are great for lungs, its mostly the alpha carotene.
Beetroot has its benefits elsewhere but the post is already
long.

Adios Amigo."

Thanks Quentin

Cheers Alan, T2, Australia.

Sorry to see this so late, but my ISP has been having technical
trouble.

According to both my retinal specialist and the ophthalmologist, BP
control is almost as important as BG control regarding retinopathy.  

I sure can empathize there. For me, it's by far the most fearful of
diabetic complications, bar none.  

However, one very important thing to remember is that by catching it
early, you will probably be fine.

I liked the fact that your Doc admitted that he didn't know something,
but I'd also suggest seeing a retinal specialist for an opinion.

If you find any, please let me know!
For what it's worth, both my ophthalmologist and retinal specialist
say keep the A1c below 6.

Sorry to hear of your pessimistic news, Ricavito... Maybe you can
bring that a1c down a little... You are not doing all that badly now.

I fear I will be hearing some of my own dismal tidings next week from
my opthalmologist, so I know how you must feel. Let us know how you
make out with this.

Will, T2