Diabetes: The Sugar Sheriff

First things first, let's talk diabetes. Diabetes is a chronic condition that affects millions of people worldwide. You've probably heard of this condition before, the pancreas is like the sugar sheriff of your body. It's in charge of regulating the sugar levels in your bloodstream.

When you have diabetes, it can sometimes go a little overboard, leading to sugar levels that are too high or too low. If left unchecked this can lead to a range of problems including foot problems, nerve damage (neuropathy), kidney problems (nephropathy), heart problems (heart attack), gum disease, stroke, and of course eye problems. Now, you may already be aware that diabetes can affect the back of the eyes retinopathy a lesser known but prevalent complication of diabetes is Dry Eye disease.

Meet Your Tear ducts: The H2O Helpers

Every blink you make refreshes a very thin layer of moisture across your eye’s surface, called ‘tear film.’ This tear film is more important than it looks because it:

• Helps you see clearly
• Keeps your eyes comfortable
• Provides nourishment for the surface of the eye
• Protects the surface of the eye
• Washes away debris

 Your tears are produced by tiny tear glands, these tear-producing machines are always hard at work, ensuring your eyes stay well-lubricated and comfortable.  Our tears themselves are also important, as your tear film is a beautifully complex structure that we all take for granted, until something goes wrong.

Our tears contain three layers each with its own unique role to play in maintaining the comfort and health of our eyes.

• The outer lipid (oily) layer stops our tears from evaporating too quickly.
• The middle watery (aqueous) layer provides nourishment to the cornea (the transparent bubble at the front of the eye that focuses light onto our retina) as well as containing antibodies to protect the eye against infection.

The inner mucin layer ensures the tears adhere to the surface of the eye. Any imbalance in the quantity or quality of these tear layers will make your eyes uncomfortable and may need some extra help. 

Imagine a machine with moving parts – your eyelids move around 50km per year and you blink around 10,000 times each day, so both ‘the parts’ and ‘the lubricant’ in between have to be optimal.

The link between diabetes and dry eye lies in the impact of high blood sugar levels on various bodily functions. Here are some key factors that contribute to dry eye in individuals with diabetes:

Nerve Damage: Diabetes can damage the nerves throughout the body, including those that control tear production. This damage can disrupt the signals that stimulate the production of tears from the tear glands, leading to decreased tear production and dry eyes.

Inflammation: Chronic inflammation is a common issue in diabetes, and it can also affect the eye's tear-producing glands. Inflamed glands may not function properly, resulting in poor tear quality.

Reduced Sensation: Diabetes can lead to a decrease in corneal sensitivity, meaning that individuals with diabetes may not feel the usual discomfort associated with dry eyes. This can delay diagnosis and treatment.

Common Symptoms of dry eye

Dry eye syndrome in people with diabetes can cause a range of symptoms, including:

•  Persistent dryness and a gritty sensation in the eyes.
• Redness and irritation.
• Excessive tearing due to the eye's reflex response to dryness.
• Blurred or fluctuating vision.
• Light sensitivity.

Management and Prevention of dry eye in diabetes

 As with all health challenges, it is always best to work with your healthcare team to stay on top of your diabetes management and this also includes with your eye care practitioner to ensure your eye health is managed too.   

Here are a few tips on preventing dry eye:

• Blood Sugar Control: Maintaining good blood sugar control is paramount in managing diabetes-related dry eye. Stabilizing blood sugar levels can help reduce nerve damage and inflammation.
• Regular eye exams: This is imperative for people with diabetes. Whilst prevention is better than cure, early intervention can prevent complications. Routine eye examinations not only offers your eye care practitioner an opportunity to detect complications such as diabetic retinopathy and cataracts, but to also offer expert advice on managing dry eye. 
• Lifestyle Adjustments: Making certain lifestyle changes can also help. Avoid smoking, limit screen time use, and use humidifiers to add moisture to indoor air. Eating a diet rich in omega III fatty acids and staying well hydrated can be useful too.
• Heat treatment: use of a reusable warming eye mask such as the Blepha EyeBag daily will not only provide relief from the symptoms of dry eye but will help soften the oily secretions from the meibomian glands, which are found in your eyelids; this will help improve the quality of your tears. In more severe cases use of BlephaSteam moist heated goggles can be more effective.
• Lid hygiene: thoroughly cleansing the eyelids daily with Blephaclean eyelid wipes will reduce symptoms associated with blepharitis.
• Artificial tears: Over-the-counter artificial tears can provide relief from dry eye symptoms. Preservative-free formulations are often recommended to avoid potential irritation caused by preservatives. There are a variety of options available to you depending on the type and severity of your dry eye including:

• Mild to moderate dry eye – Thealoz Duo
• Severe dry eye – Thealoz Duo Gel
• Evaporative dry eye – Thea Lipid

 

Start giving your eye some TLC (Théa Loving Care). You can use our online symptom checker to help you identify the symptoms you may be experiencing. We always recommend you talk to an eye care professional who will be able to diagnose your symptoms and offer advice to support you.