Contributed by: Ashley Rife and Anojinie Karunathilake, Class of 2017 Fellows
Through outreach activities our goal, is to help educate the public and our patients about the importance of taking medications as prescribed. As part of our efforts to spread the word about medication adherence, our students are writing articles and blog posts related to three specific disease states–cardiovascular disease, diabetes, and respiratory disease.
There are several vision related complications that can arise in patients with diabetes. These include diabetic retinopathy, cataracts, and glaucoma1.
- Diabetic retinopathy: the most common form of diabetic eye disease where there is damage to blood vessels in the retina
- Cataract: clouding of the lens
- Glaucoma: damage done to the optic nerve that is often resulted from high blood pressure2
The risk for diabetic eye disease increases the longer a person has had diabetes. Older adults, African Americans, Native Americans, Hispanic/Latino populations are at a higher risk for developing vision loss due to diabetes1.
According to National Eye Institute of National Institutes of Health (NIH), you can follow these simple steps to keep on ‘TRACK’ (see picture)1.
Take medications as directed by your doctor
Reach and maintain a healthy weight
Add physical activity
Control your ABC’s (A1c, Blood Pressure and Cholesterol)
Kick the smoking habit
Take Your Medications As Prescribed by Your Doctor
It is very important you take the medications as instructed by your doctor1. Your pharmacist and doctor can help you with appropriate technique, storage, and dosing. In order to help preserve good vision it is necessary to stay in control of your blood sugar1. Taking your diabetes medications as prescribed and testing your blood sugar appropriately will help to keep your diabetes under control. Fasting blood sugar (the blood sugar in the morning before breakfast) according to the American Diabetes Association guidelines should be less than 110 mg/dl3. Blood sugar readings after a meal according to the guidelines should less than 140 mg/dl. High blood sugar over time can damage your eyesight. If you keep your blood sugar levels steady (in control), you can slow the damage to the tiny blood vessels in your eyes. Lastly, it’s recommended you keep a log of your blood sugar readings and bring that to your pharmacist and physician so they can help you better control your blood sugar. Keeping a log will also help with adhering properly to your medication regimen.
The Importance of Taking Medications that Aren’t Specifically for Diabetes
There are also several medications that are not necessarily prescribed for diabetes that are important to take as prescribed. These include medications for high blood pressure and high cholesterol. High blood pressure alone can lead to eye disease. If you have high blood pressure and diabetes, you need to be even more careful about how you manage your conditions. Although you may not feel “sick” from high blood pressure, it is important to take your medication daily as prescribed. Ask your doctor to check your blood pressure at every visit. Check with your local pharmacist and see if they provide blood pressure checks. No appointment needed! For most people with diabetes, your goal blood pressure should be less than 140/904. Be sure to have your cholesterol levels checked annually. All it takes is a simple blood test to find out how much “bad” (LDL) and “good” (HDL) cholesterol you have. Too much LDL is linked to blood vessel damage.
- NIH NEHEP. Stay on TRACK to Prevent Blindness from Diabetes. https://nei.nih.gov/sites/default/files/nehep-pdfs/NDM_SM_Toolkit_2015.pdf. Accessed February 15, 2016.
- Mayo Clinic. http://www.mayoclinic.org. Accessed February 11, 2016.
- American Diabetes Association. Standards of Medical Care in Diabetes-2015. Diabetes Care. 2015;38:1-94.
- Dennison-himmelfarb C, Handler J, Lackland DT. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520.