Diabetic Retinopathy

What is diabetic retinopathy?

Diabetic retinopathy is a diabetes complication that affects eyes caused by the damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). It can cause vision loss and blindness. It develops in type 1 and type 2 diabetes and can also affect those who are diagnosed with gestational diabetes. The longer you have diabetes and less controlled your blood sugar is, the higher your risk of developing diabetic retinopathy.

What causes diabetic retinopathy?

When there is too much sugar in your blood it can lead to the blockage of the tiny blood vessels in your eye, cutting off its blood supply. This causes new blood vessels to grow but they aren’t developed properly and can leak easily.

Are there any conditions that can be caused by diabetic retinopathy?

Yes, there are a couple of conditions that can be caused by diabetic retinopathy.

  • Diabetic macular edema: 1 in 15 diabetics will develop DME. DME occurs when the blood vessels in the retina leak fluid into the macula causing blurry vision.
  • Neovascular glaucoma: the growth of new, abnormal blood vessels can interfere with the normal flow of fluid out of the eye and pressure can build in the eyeball, this heightened pressure in the eye can cause damage to the optic nerve that carries images from the eye to the brain resulting in glaucoma.
  • Retinal detachment: the leaking of the new blood vessels causes scars to form in the back of the eye. The scars pull your retina away from the back of the eye.

Can diabetic retinopathy be treated?

There are several treatments for diabetic retinopathy.

  • Injections: anti-VEGF drugs or corticosteroids can slow down or reverse diabetic retinopathy.
  • Laser treatment: to reduce swelling in your retina, lasers can be used to make blood vessels shrink and stop leaking.
  • Eye surgery: if retina is bleeding a lot or you have a lot of scars, your eye doctor may recommend a vitrectomy.

Having high cholesterol or high blood pressure along with diabetes can increase your odds of getting diabetic retinopathy. You can start to see floaters in your vision, blurred vision, fluctuating vision, dark or empty areas in your vision, or vision loss.

Early diabetic retinopathy or non-proliferative diabetic retinopathy (NPDR), is when the new blood vessels aren’t growing properly. They are weakened as more vessels become blocked.

Advanced diabetic retinopathy or proliferation diabetic retinopathy, the damaged blood vessels close off causing the growth of new abnormal blood vessels in the retina. They are fragile and leak into the clear jelly-like substance that fills the center of the eye (vitreous). The scar tissue from the growth of new blood vessels can cause the retina to detach from the back of the eye or cause a build up of pressure in the eye.

Diabetic retinopathy is preventable with proper management of your diabetes. Having uncontrolled high blood sugar over a long period of time can increase your risk of getting diabetic retinopathy. So in order to prevent it, you need to stay physically active (150 minutes per week at least), eat healthy, and always take your medication when you are supposed to.


References

Mayo Clinic
NEI
American Academy of Ophthalmology

Files

Season Three: Episode Three

JANUARY 24, 2022

Nothing much to report. This past week I’ve had a couple of high blood sugar days and I can tell because I’ll get extremely thirsty, very hot, and really tired. I think it was Wednesday or Thursday, I literally slept almost the entire day. That’s not good.

I’ve been keeping up with my oral medication but without insulin, I’m pretty much on my own. I’ve restarted my Ozempic though. I’m gonna use it until my pen runs out then I won’t have anything. My insurance kicks in next month so hopefully I’ll be able to get insulin again. Hopefully.

I’ve started doing thirty minute walks with my dog. She’s a bit chunky too so the exercise will be good for both of us. Although, I think the other day I went walking without having eaten much and my sugar went a bit too low that my liver compensated. And I know this because during my walk I was getting weak and then that night I felt like I was running a temperature I was so damn hot.

But of course I’m an idiot and forgot to take my blood sugar before and after. I’ve been pretty lax on taking my blood sugar recently. Kind of really fed up with needles. I know I should get back to it, but I don’t particularly want to.

Hey, did you hear about Mark Cuban’s new pharmacy? They’re supposed to be transparent about their prices and offer medication at a cheaper cost. Unfortunately, they don’t have insulin, but they do have other medication you might be interested in. You can check it out here if you want to.

Hopefully next month things will get better. I’ll keep making good food choices and exercising when I can. I can do this. This is my health and life at stake here. I can do this!

Light of the Jedi

I found this book at Walmart. It can also be found in Target and possibly your local bookstore.


Author: Charles Soule
Publisher: Del Rey
Genres: SciFi, Action/Adventure
Rating: ⭐️⭐️⭐️⭐️⭐️/5

Following the perspectives of several characters in the Star Wars galaxy, we follow a timeline of an accident in hyperspace and the consequences of it. Then we follow along various events that occur around the galaxy simultaneously, political decisions, secret hideouts, and rescue missions.

It’s a wonderful adventure that dives deep into the Star Wars galaxy and we get to see a glimpse of the new version of the High Republic. I’m still bitter that Disney canned all the Old Republic and Solo twins etc. But I was pleasantly surprised with this story all the same and I am definitely going to read the next book.

The bridge ripped open. Hedda Casset died, not knowing if she had saved anyone at all.

Light of the Jedi

Learning how the Jedi dynamic was during the High Republic was very interesting. Plus their technology was way cooler back then as well. The detail and story telling of what technologies are available, how hyperspace works, and how disconnected the Outer Rim was during the High Republic and then the question of why it’s still disconnected during the Old Republic timeline.

It has definitely raised a lot of questions for me and I suppose I’ll just have to keep reading to learn more. I highly recommend this read for Star Wars fans out there. Even if you’re just as upset or more upset about Disney’s takeover and erasure of the old content, it’s still a really great read and it adds more to the galaxy we all love. If you’re not a Star Wars fan or haven’t seen any material from Star Wars at all, you might get confused by alien species and some other stuff but you don’t need to have watched the movies beforehand. You could be absolutely new to Star Wars and you’ll be able to follow along.


2022 Reading Goal

Book #2 out of 50

Diabetic Ketoacidosis

What is Diabetes Ketoacidosis (DKA)?

Diabetic ketoacidosis is a serious and life threatening condition that impacts primarily type 1 diabetics but can also occur in type 2 diabetics.

How does it occur?

It happens when your body can’t produce enough insulin to help your body’s cell absorb the glucose in your blood to provide energy to your body. So instead your body starts breaking down your fat. Your fat gets broken down by the liver for your body to use as fuel, usually occurs when you go a long period of time between meals.

When your liver breaks down the fat it produces acids called ketones. If fat is broken down too quickly, a buildup of ketones occurs in the bloodstream causing your blood to become acidic. Ketones can overflow from the bloodstream into your urine. If there is a prolonged buildup of ketones in the blood, it could lead to death.

How do I know if I have DKA?

Symptoms occur quickly, usually within 24 hours.

  • Excessive and prolonged thirst
  • Stomach pain
  • Fruity-scented breath
  • Frequent urination
  • Weakness or fatigue
  • Confusion
  • Nausea and vomiting
  • Shortness of breath
  • Dehydration
  • Headache
  • Deep, rapid breathing
  • Flushed face
  • Muscle stiffness

For more specific signs, you can use home testing kits to test for high blood sugar level or high ketone levels in your urine.

What should I do when I start showing symptoms?

Contact your doctor immediately if you are vomiting or unable to tolerate food or liquid, your blood sugar level is higher than your target range and home treatment is not helping, or if you have moderate to high ketone level in your urine.

Seek emergency care if your sugar is consistently higher than 300 mg/dL, you have ketones in your urine and are not able to reach your doctor for advice, or you show any of the other signs of DKA.

How can I prevent DKA?

  • Commit to managing your diabetes. Eat a healthy diet, engage in regular physical activity, take your oral medication and/or insulin every day as needed.
  • Monitor your blood sugar. Check 3 to 4 times per day, more if you are ill or under extreme stress.
  • Adjust your insulin as needed. Contact your doctor or diabetes educator to learn how to adjust your insulin.
  • Check your ketone level.
  • Be prepared to act quickly.

References

Mayo Clinic
Medline Plus

Season Three: Episode Two

JANUARY 17, 2022

Things are slow going. I’m still trying to get health insurance through Healthcare Marketplace. I’ve got it but they need to verify my credits used towards it and that takes a hot second. I’ve already got my dental plan going. I have to wait until after February 1 to do any doctor appointments.

I haven’t seen my endocrinologist since, I think, last September. I haven’t gotten my current A1C done since then.

I saw my eye doctor last month and I can push my appointments to four months apart instead of three but I need a visual field test in March first. Not gonna lie I think my visual field is a bit bad. My peripheral has some blank spots, not good. It’s mostly my left eye that’s giving me problems. If I don’t get my diabetes under control I’m gonna need eye injections and those don’t look fun AT ALL!!

My feet have been okay lately. I still get random cramps but I can still feel things so that’s a good sign. I don’t want to lose feeling in my toes.

I can’t wait to find a dentist. I haven’t seen one in three years. My teeth may need some help to be honest. I found our my family on my mom’s side has teeth problems. Not sure if it’s genetic or not but my mom, her siblings, and her mom all have missing teeth for whatever reason. I need to take care of my teeth.

I’ve lost two pounds last week since the week before. Weigh in days are Thursday mornings so we’ll see if I’m still losing. I am taking advantage of being at home and having a dog. Yesterday we went on a half hour walk around the neighborhood. It’s the longest walk we’ve taken in a while and we were both exhausted afterwards. I need to make it a regular thing. She needs to lose weight too.

Thanks for sticking around. I really appreciate you.

Blood Like Magic

This book was a BookTok recommendation. The author is @lisellesambury on TikTok if you want to check her out. The sequel to this book is coming out later this year.


Author: Liselle Sambury
Publisher: Margaret K. McElderry
Genres: Young Adult, Fantasy, Urban Fantasy
Rating: ⭐️⭐️⭐️⭐️/5

Voya Thomas has finally Come of Age. She is ready to receive her Task, Pass, and become a full witch with a Gift of her own, just like her grandma, parents, and cousins before her. She has difficulty making decisions and has little confidence in herself to actually pass her task, but nevertheless, she doesn’t want to let her family down. However, she is given an impossible task. She must destroy her first love in order to save her family’s magic. If she chooses to decline her task, every Thomas after her will never receive magic. If she accepts and fails her task, every Thomas alive today will be stripped of their magic. How can she be the one to hold the fate of her family’s magic all on her own? She can’t fail her family.

This book is set in the not-so-distant future of about 2030, but in this future, it’s all about genes and genetic modification. It’s also about the struggles of the marginalized black community; how it’s difficult to make money and get an education, not unlike today. The importance of heritage and culture is also spotlighted in this story. Family is literally one of the pillars of this book.

The ancestors of these witches may grant those who pass their task a gift that could be anything from reading minds to fire manipulation. Each witch also has access to magic through blood and intent. They’re split into those who are pure and those who are impure. Impure witches get the majority of their power through spilling someone else’s blood. Each family has a Matriarch. She is able to speak with the ancestors and lead her family.

I love the mechanics behind the magic and how every family in their witch community is connected. The characters and their stories are great. The backstory of how their community became the way it is because of the influence of genetic modification and those who have money to get modifications and those who don’t.

I wish the other characters had more depth. Voya and her cousin, Keis, are in the story much more than everyone else and they have a bit more depth to them than everyone else. It feels a little rushed when we’re introduced to characters and then it’s very shallow and not very flushed out. For example, Luc is our arrogant love interest who has some sort of hobbies and back story that we get little snippets of and then we’re moving on. I wish we could have learned more about Alex, another Thomas cousin, and Luc.

The hardest part for me with this book was I couldn’t connect with it. That’s really just me though because I am not black myself and I don’t know anything about Canada and Trinidad. I don’t know some of the words she used or the cultural references. It was really great to read about another culture, but I found it very hard for me to connect with the story which is why I relied more on the characters and their stories. It took me a lot longer to get through this story than I would have thought but I still loved it and I can’t wait for the next book to come out.

I highly recommend this book if you like fantasy stories about magic and love. If you like stories rooted in family values and morals, this is the one for you. If you want to read a story about a black girl, written by a black girl, this one is definitely for you.


2022 Reading Goal

Book #1 out of 50

First Use of Insulin on a Human

Today marks 100 years since insulin was first used on a human being to treat diabetes.

A little history on the discovery of insulin.

Insulin was discovered in the pancreas by two German researchers, Oskar Minkowski and Joseph von Mering, in 1889. They also made the connection between polyuria (excessive urination) and diabetes, and tested glucose levels in the urine of animals. Mering and Minkowski also discovered that total pancreatectomy in dogs produces severe diabetes and could not survive very long without their pancreas.

In 1910, Sir Edward Albert Sharpey-Schafer suggested that only one chemical was missing from the pancreas in people with diabetes and came to call this chemical, insulin. From the Latin word “ínsula” meaning island, referring to the insulin-producing pancreatic cells known as the islets of Langerhans.

In 1921, a young surgeon named Frederick Banting and his assistant Charles Best figured out how to remove insulin from a dog’s pancreas. They were able to inject the healthy dog’s insulin in to a dog with severe diabetes and keep it alive for 70 days. The dog only died when there was no more extract to inject. Banting and Best worked with biochemists James Collip and John Macleod to develop a more refined and pure form of insulin from the pancreases of cattle.

A year later, in 1922, a 14-year-old named Leonard Thompson, was dying from type 1 diabetes in a Toronto hospital. On January 11, 1922, he was given an injection of slightly purified insulin and within 24 hours, Leonard’s dangerously high blood sugar levels dropped. However, he developed an abscess at the injection site and still had high levels of ketones.

James Collip continued his work on purifying insulin so it would be safe for human use and on January 23, 1922 Leonard was given a second injection and it was a complete success. Since the very first insulin injections, we have come a long way in diabetes care.

We have access to insulin pumps, continuous glucose monitors, oral medications, different varieties of insulin, diabetes phone apps, and better research in diabetes now. We also have access to pancreatic transplants. Though they may not be affordable to everyone now, we can only hope that one day it will be available for all.


References

Mayo Clinic Proceedings
American College of Cardiology
Diabetes.org.uk
Diabetes.org

Season Three: Episode One

JANUARY 9, 2022

Happy New Year! It’s been a long while. 2021 was not a good year for me. I lost myself a little bit and it took me a little while to get back to myself. My insurance switched prescription providers or whatever and they no longer authorized insulin. My endo and I tried to get authorizations for all kinds of insulin and they were all denied. Meaning I’d have to pay out of pocket for my insulin. Like I could afford that. But you know what they did authorize? Ozempic, that $400+ pen that you inject once per week. Yea they said I could get that. But Ozempic IS NOT A SUBSTITUTION FOR INSULIN. So I could get Ozempic but not insulin. I’ve had to try other ways to manage my blood sugar and I felt defeated when nothing I was doing on my own was working so I stopped checking my blood sugar and I’ve just been injecting Ozempic.

I am trying to turn my health around. I made a weight loss journal to track my weight loss. I’ve lost ten pounds since starting so I’m glad that I’m losing weight and maybe if I lose enough, it’ll make a great impact on my health. I’m down below 190 pounds and that’s great for me. I will continue to lose weight and exercise as best I can.

I need to be more present with my health. I want to get better because I want to be here for my family. One day I want to start my own family and I want to be as healthy as I can when I do. I feel like I’m running out of time. I’m 27 now and I feel like it’ll be harder after 30. I need to make lifestyle changes now. My sister is also trying to get her life together so we’re kind of doing it together. My husband is also losing weight with me so I’m not alone here. Also we made weight loss goals. When we reach a goal amount of pounds lost, we get to reward ourselves. My first reward is at 15 pounds lost. When I reach it, my husband will buy and build a gunpla of my choice and let me display it. He’s the one who loves building them but I like looking at them. They’ve been coming out nice and I want one for myself. I might even help him build it too if he’ll let me.

I am very hopeful for this year in my health. I will make the changes I need to this year. It just feels all very overwhelming. But I will make it through. I’m not alone in this. I know I’m not and that helps. Thanks for hanging around. I really appreciate you.