Diabetes robbed me of my eyesight, so check your insulin levels and be active

Though blind in one eye from diabetes complications, Patrick Muema, an officer with the National Police Service has since seen the light, literally.

Today, he encourages persons with diabetes to seek annual eye care to save their vision and much more.

The father of two says losing sight in one eye has taught him that being proactive at both personal and community level will not only save his vision in the other eye, but will improve the quality of life for others in similar condition.

“I have adjusted to getting by with one eye, but I realise prevention of sight loss is key and a deliberate journey an individual commits to when diagnosed with diabetes,” says Muema. Muema’s story is revealing.

“The risk of diabetes complication increased when I was involved in a road accident and was admitted for three months. After I was discharged, I started feeling particles in both eyes and my vision in my right eye worsened,” Muema says.

Excessive thirst

The 57-year-old suspected he had diabetes in 1987, when he worked in Garissa. “I began experiencing excessive thirst, fatigue and having frequent hot and cold sweats.

I did not pay much attention to it until years later, when a medical examination confirmed my fears,” Muema tells The Standard on Sunday.

He was diagnosed with diabetes in 1994 while on a trip to Kangundo, his home village. The verdict set off a journey that called for a shift in lifestyle, in order to maintain almost-normal levels of his blood sugar.

Muema had been living a relatively normal life when he shockingly realised that sight in one of his eyes was failing. This prompted him to seek urgent treatment to save his eyesight. Soon, it was confirmed that he had lost sight in his right eye. “I have had two surgeries on my eyes, the most recent one in 2010. I am aware that observing my blood sugar levels is key for all organ functions.

I advise people to go slow on alcohol, nyama choma, fatty foods and to walk regularly to reduce the risk of acquiring diabetes,” Muema says.

Dr Michael Gichangi from the Health Ophthalmic Services Unit at the Ministry of Health warns that diabetes can affect your eyes in a number of ways, with the most serious eye condition being loss of sight due to the damage of the network of blood vessels supplying the retina, a condition known as diabetic retinopathy.

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.

Insulin is a hormone that regulates blood sugar. Whereas not all patients diagnosed with diabetes get the complications, they are at higher risk of loss of the lower limbs to amputation, stroke, blindness, kidney failure and even a heart attack.

Statistics indicate that Kenyans are widely ignorant about the disease,and one in five people with diabetes are not aware that diabetes can affect their vision.

According to the World Health Organisation, prevalence of diabetes in Kenya affects 3.3 per cent of the population, with the rate expected to rise to 4.5 per cent by 2025.

Some of the reasons given for eye care not being prioritised by patients with diabetes include poor advisory services in some health facilities, an assumption that their vision is good thus they do not need screening and treatment; cost of healthcare, fear of laser treatment and fear of its impact on quality of life and jobs.

Long waiting period for screening or treatment, complicated referral mechanisms and inaccessible locations have also been cited as health-seeking challenges.

“I attend two clinics - one for diabetes management to monitor my blood sugar levels and another to ensure that the sight in the remaining eye is not affected,” says Muema, who spends an average of Sh6,000 per month on treatment. Global estimates show that at least one out of every three persons with diabetes has impaired vision, a situation that can be reduced by keeping blood glucose, cholesterol and blood pressure at near normal levels as possible.

Dr Gichangi estimates 220,000 Kenyans are blind from various causes and advises an eye examination by a qualified eye health worker annually to ensure diabetic eye disease is picked in the early stages before it causes loss of vision.

“We encounter challenges in diagnosing diabetic eye diseases because they are painless. Even when there is vision loss, it is progressive and the patient tends to delay seeking treatment,” says Dr Gichangi.

According to him, the commonest cause of loss of vision in patients with diabetes includes cataract, glaucoma and a condition known as diabetic retinopathy, which refers to damage to the blood vessels of the light-sensitive tissue at the back of the eye. Whereas loss of vision due to cataract is reversible by simple cost effective surgery, glaucoma and diabetic retinopathy are not.

“The hallmark of avoiding any complications related to diabetes is accurate sugar control and this can be achieved through diabetes education, physical exercise and relevant dietary recommendations,” Dr Gichangi says.

He acknowledges the role of social support: “Support groups discuss the fine details of relevant issues and are able to support one another with practical solutions, say regarding nutrition or monitoring blood sugar at home, based on what is accessible to them,” says Dr Gichangi.

Grateful to continue seeing the beauty of the world, Muema challenges persons with diabetes to seek annual eye tests and adhere to diabetes control advisories given the accrued health benefits, saving their eyesight. “For how long shall ignorance blind us to ignore vision loss as a complication of diabetes?” he asks.