When you go to your doctor, they always ask you if you have diabetes or hypertension. They ask this because it affects almost every part of the body. According to an estimate by the International Diabetes Federation Atlas 2019, India’s adult population is expected to have around 77 million cases of diabetes by 2019.
However, usually when people think of diabetes, they think of type 1 (autoimmune) diabetes and type 2 (adult-onset or diet-related) diabetes. However, gestational diabetes is also a third type of diabetes which often occurs due to lack of proper care and is diagnosed in the same way as other diabetes. It is diagnosed when a woman has never had symptoms of diabetes before, but suddenly symptoms of diabetes start appearing during pregnancy2.
Gestational diabetes and diabetic retinopathy
A lot of changes go through in the body of women during pregnancy and diabetes interferes with the way the body regulates itself. If left untreated or untreated, gestational diabetes can harm both mother and baby during and after pregnancy. Gestational diabetes, for example, is associated with hypertension during pregnancy. This increases the risk of a woman having a stroke or blood clots during childbirth. Uncontrolled gestational diabetes can also cause low blood sugar in the baby at birth.
Another cause of concern is diabetic retinopathy in pregnant women. Diabetic retinopathy is an eye disease that, if left untreated, can lead to blindness and even complete blindness. Diabetes causes retinopathy because high blood sugar, the main cause of diabetes, damages the small blood vessels that support the retina in the back of your eye. Over time, this damage can cause blood vessels to bleed, leak out fluid, and block them. Worse yet, in gestational diabetes, the prevalence of diabetic retinopathy has been observed to be between 10% and 27.76.
It’s scary isn’t it? But what if you are a woman with type 1 or type II diabetes and also pregnant? Before the discovery of insulin in 1922, women with diabetes were at high risk of pregnancy complications. Although there is no long-term effect of pregnancy on diabetic retinopathy, retinopathy progresses rapidly in 50%-70% of cases. The greatest risk of worsening occurs during the second trimester and continues for up to 12 months after delivery.
Who is at risk?
Research shows that women with type 1 diabetes are at higher risk. According to a research published in the Indian Journal of Ophthalmology, the prevalence of diabetic retinopathy was 57%-62% among women with type 1 diabetes and 17%-28% among women with type 2 diabetes4 in a first-time investigation.
The prevalence of DR during early pregnancy in women with type 2 diabetes has been observed to be 14%, compared to between 34% and 72% in type 1 diabetes. If you are a woman with diabetes, ask your doctor to check the DR at different stages of your pregnancy4.
Currently, both pregnancy and childbirth can be safe for most women with diabetes. This can happen in the same way as people without diabetes. This improvement is mainly due to better blood glucose (sugar) management. This requires a proper diet, frequent monitoring of blood glucose on a daily basis, and frequent adjustment of insulin.
How can I manage my diabetic retinopathy risk?
Prevention and treatment of diabetic retinopathy, like most diseases, begins with preventive testing. Your primary care physician or OB/GYN should check you for gestational diabetes7. If your results are positive, then you should go to your eye doctor and get a complete eye exam done.
In the case of diabetic retinopathy, there are usually no signs or symptoms in the early stages, but the best and only way to catch it early is to stop it from progressing5.
As we all know, we are not fully aware of this risk. Hence, Network18 in association with Novartis launched the ‘Eye Suraksha’ – India Against Diabetes initiative to create awareness about diabetic retinopathy among the masses. Diabetic retinopathy is a threat to your eyesight and there are many ways to prevent it. This initiative will start a series of awareness camps at the grassroots level across the country.
To learn more about diabetic retinopathy and its effects on your loved ones and yourself, visit (link to microsite) for more information. To get more updates on the ‘Eye Protection’ initiative, follow News18.com and prepare to join India’s fight against diabetic retinopathy.
1) Pradeepa R, Mohan V. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021 Nov;69(11):2932-2938.
2) Gestational Diabetes. Available [online] at URL: https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339. Accessed on August 3rd 2022.
3) Gestational diabetes and Pregnancy. Available [online] at URL: https://www.cdc.gov/pregnancy/diabetes-gestational.html. Accessed on August 3rd 2022.
4) Chandrasekaran PR, Madanagopalan VG, Narayanan R. Diabetic retinopathy in pregnancy – A review. Indian J Ophthalmol 2021;69:3015-25
5) Diabetic Retinopathy. Available [online] at URL: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy. Accessed on August 3rd 2022.
6) Patient education: Care during pregnancy for patients with type 1 or 2 diabetes (Beyond the Basics). Available [online] at URL: https://www.uptodate.com/contents/care-during-pregnancy-for-patients-with-type-1-or-2-diabetes-beyond-the-basics. Accessed on August 3rd 2022.
7) Mallika P, Tan A, SA, TA, Alwi SS, Intan G. Diabetic retinopathy and the effect of pregnancy. Malays Fam Physician. 2010 Apr 30;5(1):2-5.
Tags: diabetes, Pregnancy
FIRST PUBLISHED : September 12, 2022, 19:36 IST