Recent diabetic retinopathy

alg said:
only with good control has stagnated for 11 years

It is very hopeful to read things like that, thinking in the long term.I'm very happy to hear it

@Oftalmologo thanks for your interesting contributions, as always.

Hello chic@s !!I am made a kaos.I have been with diabetes for 35 years and I have 38. Towards years that the ophthalmologist visited me every 3 months and on a visit he told me that I would see myself at 6 because I was better.To all this I was preparing to give me ok to get pregnant.My endocrine is approved and when I go to the ophthalmologist M says that I have had a spill (I neither find out) I did treatment with laser and managed to stabilize it.I stay pregnantly, I lost it.I have been for two years without being able to stay for gynecological problems that have nothing to do with diabetes.Well, they give me a gynecologist and I have another little spill again, this was in October.I have been made of intravitrea and laser injections, and my ophthalmologist told me last month that gives me approval, that we saw each other in a month to do a little d laser, but that I had its consent.He told the endocrine and tells me that it is contradictory to give me an approval and that I would make me laser, to ask him for a report with which he is stable and he has sent me to the ophthalmologist of his hospital.Today I have gone to the usual ophthalmologist and tells me that whether it is stable or not, until in a few years you cannot know with a diabetic retinopathy, that I am very good and that it believes that it is a good time to stay, it has explained risks that risks qThey can be run and more ... it has made me report but it does not make it stable, it makes me that it presented Panfotocoagilado and controlled retinopathy.And that there is no contraindication to get pregnant, I think that my endocrine will not give me approval with that ... I am made a mess ... do not start looking or better to wait, it is that waiting for me to come to the ophthalmologist andSuch ... can spend a couple or three of months, and as you will understand, then D 5 or 6 years waiting ... instead of being happy because everything has gone well, I am a total driver hehe (sorry for the paragraph butI needed to vent

@Shaki to see what they tell you here.I don't have much idea about what you tell, in my case they have not treated me laser or anything and I don't know what to tell you.Yes I can tell you that before I was pregnant I had my annual review with the ophthalmologist and it went to him that I asked about the risks of retinopathy and pregnancy and in my case they told me that retinopathy did not have to move forward if the glycemia wereGood during the 9 months (with everything that vary insulin needs), but of course each case is different.I just tell you that the ophthalmologist's opinion seems more important than the endocrine, which is supposedly the most experience in it.
Cheer up.

Thank you @alg to see what I do ... on Monday I go will call the endocrine and according to what I tell me, who knows, Alomejor say what I say I start looking and what is what I have to be.Nor is it that they go, to me the ophthalmologist has told me that if

Shaki, from my point of view, it is necessary to understand how retinopathy develops, to understand it and to fight it.I will try to explain it although it is not easy.
The (diabetic retinopathy) RD is developed from alterations of the small blood vaos of the retina, which are altered their walls by the presence of an excessive amount of glucose causing the weakening of the vascular wall.Simultaneously, thickening of arterial walls occurs due to the loss of cells, pericitos, that control that growth.And in addition, a loss of the deformity of red blood cells (blood cells) that, under normal conditions, are deform or stretch when the vessels where they have to circulate are too narrow.Having lost this quality, microtrombosis occur, and because of the weakness of the wall, microhemorrhagia and microaneurisms.All this in absolutely microscopic dimensions and without any impact on vision.
Over time, all these injuries grow and reach extensions, already considerable, and at that time, they begin to be visible in the background.
The real problem occurs when these retinal areas that have serious blood irrigation problems, begin to manufacture as compensatory mechanism, neovosses that do not have the same structure as normal vessels and that bleed with extreme ease.These neovants grow and to sustain themselves, create a fibrous structure that adheres to the retina and that later traction it, causing a detachment.This is the terminal and the most serious phase of the RD, and once reached, it can only be treated by surgery, but the real treatment is to prevent this phase from reaching, and that is only possible if it is known that it will occurand is detected in time.That is, seeing it coming is easy: first studying the disease and knowing it and second, detecting it before it is visible through angiofluoresceingraphy (AFG).Through vein injection (the arm, not that of the eyes) of a dye, you can distinguish sick retinal areas that in the future can constitute anxic areas (without irrigation).It is in this phase when the laser comes in function.
The laser is not an antibiotic or a miracle that can convert a sick retina into healthy.The laser is nothing more than a cauterizer who, in essence, intends to destroy the sick retina that is somewhat toxic, so that it does not reach serious phases that can endanger the vision.But the destruction of an anoxic retina must be complete and for that you have to know exactly the dimension it has.In other words, the laser is an instrument that is used to get an end, and if that end is not known, it is difficult to achieve it
Conclusion: a “spill“ is a consequence of a problem.You have to treat the problem, not the spill.AFG is indispensable, to diagnose the RD and to see its evolution
And finally, pregnancy is a risk factor for retina ... when it is not well treated.If the treatment is correct, pregnancy does not represent any problem
I understand that all this is difficult to understand.If you want me to expand any specific point, I am at your disposal

@Oftalmologo great exposure.

According to your experience, you could say more or less, generalizing, how many years does it take to develop a diabetic retinopathy in a well -controlled person?I know that each one is a world, but for example someone who always moves in hemoglobins of 6 or 6.5, should take at least 20 years to develop it as normal general, right?

Another issue, do you think that genetic particularities of each person influence the tolerance of this type of complications?
It is that I have a direct relative who has been with the disease for more than 30 years and I do not exaggerate if I say that his hemoblogine must have always been above 11 or 12. How is it possible that he has not developed very serious complications?

Thank you

@Oftalmologo Thank you very much for being in the forum, helping us and commenting everything.

@Oftalmologo thank you very much for being in the forum and helping us.Very well explained, but ... a rib ... my ophthalmologist is super nice, but I have my question, it may be that I have not treated many diabetics that this in my case, and I get the approval even if it is not the time?It is that my endocrine is expressly to give us approval and tells me that it has to be totally stable, and I already told you what my ophthalmologist told me.Q mess

By order, first artories.With hemoglobins of 6 or 6.5 it is possible that retinopathies may not develop for 20 and perhaps 30 years.And when they develop, they will be considerably less serious than those presented with poor controls.As for your relative with 11 and 12 hemoglobins that have not developed RD, you can bet and win safely, that will develop it.There are some studies of HLA antigens that supposedly protect some individuals from developing proliferating RD, but there are no conclusive results.Of course, I have encountered some patients who had had serious retina problems, and have not had them, but it is a statistically insignificant number.On the other hand, since the RD is a vascular disease, the same problems in a young person with their vascular tree free of other diseases are not produced as in patients, mainly of type 2, with other diseases that affect the arteries (hypertension,hypercholesterolemia) that, so to speak, enhance the effects of diabetes

Shaki: The eye seems to be a small thing and that it is easy to dominate, but in ophthalmology there are as many subspecialties as in any other specialty.There are digestive surgeons, specialists in endocrine surgery, cardiovuar, peripheral vascular.In ophthalmology the same happens a little, and an ophthalmologist who is dedicated to operating cataracts or retinas, it is difficult to reach an RD experience such as the medical retina specialist who is the one who recommends you to look for you.And once again, I insist: the one who makes you an angiography with fluorescein and who studies it before dealing with Laser is the one who truly understands the subject

For all: it is a pleasure to collaborate with you in your forum.I am at your disposal

@Oftalmologo I join the compis, it is fantastic for someone to explain these things so clear, it is very much appreciated.
On the complications I have a clear example of someone who has 30 years without care and with high glycosylated hemoglobins that never had a complication, unfortunately I know that in the end or change or in the end something will come out, I think that being young the sameIt takes longer, but if we don't take care of the inevitable it ends up happening

Fuck I have been 30 years old and I am expected to read this.All Hbal except the first 4 years that were below 7.5 before they said that it was good.Then below 7 and several years on average 6.5 but Jolin I am understanding that we will all give us.
The view is what gives me the most.

@jconegar I will have been like you, except that my 4 years above 7 are in between, my adolescence that passes from 8 and two years ago that the thing was to doAll my life, that or above, I fear more for her than for me, but it is already a lost battle and I will not be on top of him, he already bothers me when someone does it with me, so he does not fall into that.

@Gemater I don't know if your sister is older than you or smaller but what I know is that it is often suffered more for our loved ones than for ourselves.

@Aliciaalicia smaller than me, but it is already true that when they are others you suffer more.

@Gemater, what treatment your sister does?Having a good hemoglobin is not so difficult with good treatment and good information

@regina has already been some year than me, he has insulin Lantus and Novorapid, but he never takes care to worry and while my mother was wearing her yet, but then nothing.The option of doctors there is very good, giving him aids did not miss him, I think that more than anything is the neglect for the subject what fails ... and with that I think it can be done.
I told her about the bomb, that I carry her and delighted with her, I told her of the continuous meter or the freestyle to help, but I do not worry about thinking about it, more than anything because it is recycled that over the years we become more vague, noThere is a form !!

@Gemater to see if it enters the forum and with such not to spit some you will see how the MCG puts it.And even puts the shoes.
The pump and a good gemater?

@jconegar then look, try to convince her, to see if it is encouraged ... to the shoes I already tell you that I do not, but well, little by little hahaha

@Ophthalmologist thank you very much for your help.