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Good HbA1c results and background retinopathy

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.

Teadance

Well-Known Member
Relationship to Diabetes
Type 2
Hi,
I've just received a letter telling me I have background retinopathy and I need to aim for good blood glucose control. I had an HbA1c of 53 at diagnosis April 14. I brought it down quite quickly, to 49 then 40. Went back to 43 and now 41. This is in the non diabetic range. How much better control do they want? So why background retinopathy? It doesn't make sense, and seems like a very poor reward for results I'd been congratulating myself on. Very upset!
Td
 
Hi Teadance, don't worry, you're not the first person to find this upsetting - I think everyone does, it's a shame they can't word it better. But it's really not something that you need to worry about. Background retinopathy is something that can come and go and will not affect your sight - it's quite possible that next year when they look there will be no trace of it. As for control, just keep on doing what you have been doing, you have done really well! 🙂

I have had an HbA1c in the non-diabetic range since diagnosis, but I still got background retinopathy - as you say, how could you improve on that? Some people never get it and some people have it but it never gets any worse for decades.

You have every right to congratulate yourself - you have done an excellent job! 🙂
 
Hi Teadance
Firstly really well done on the HBA1C results they are absolutely marvellous :D. I had the same letter that you've got last year, just after being told that my A1c had dropped from triple figures at diagnosis to 45. I rang them because I was very upset and when I finally got a person they told me two important things. First background retinopathy can be one single bleed in one eye, so very minor, and secondly regaining tight control can cause it. I really wish they'd produce better information leaflets and I told them so. The Dr I spoke to also said a good number of people without diabetes will have background retinopathy caused by all sorts of things. This year my screening showed no background retinopathy. If your worried about it most opticians now do retinal photography, it isn't quite as precise as the screening but they can have a good look around. I had my routine eye test five months after my screening and had three opticians truffling around with their scopes and they found nothing at all. That made me feel a lot better about waiting 12 months for the next screening (I was in overdrive imagination wise thinking it was getting worse).

Don't let it get you down, and fingers crossed you'll get a clear screening next time 🙂
 
Thanks Northerner and KookyCat. I'm really grateful for your replies. Any ideas why gaining tight control can cause it? Seems counterintuitive, and you're right about the wording of the letter. My response would have been to cut down even further, whilst waiting for my next screening. Given what has been said about tight control, could I have exacerbated it? Although it was referred to as Diabetic retinopathy in the letter, I'm presuming this is not the type that comes with uncontrolled BG levels. If it's to do with gaining tight control, shouldn't my Dr have said at diagnosis, '....but don't lose weight too quickly.'?
Td
 
I don't know the exact science behind it, but basically the thought is that a rapid change in blood sugar control places more stress on the tiny blood vessels than a more gradual fall would do. Not all doctors are aware of this possibility, it seems. Keeping levels under good control from now on will mean that that stress is not present, so there is every possibility that the next time there will be no evidence of retinopathy. Retinopathy is graded in levels of seriousness - background retinopathy is the least serious and usually does not require any treatment or affect sight. Having recognised that it has occurred for you, at the next test they will be able to assess whether it has got better, stayed static, or progressed, so it is important that they give the assessment.

Maintaining good blood pressure levels is also important, to help reduce the risk of damage to the tiny vessels in the eyes (and also the kidneys), so that is something to watch also. 🙂
 
Thanks Northerner,
I suppose it could not be diabetic related. I've added swimming and Zumba gold to my exercise 'repertoire'. I do puff and blow a bit with the Zumba. Wonder if it could be exercise related. I'll keep an eye on things. Suppose we should be glad that they do this screening stuff. I do think the wording could have been better though. So grateful for people's knowledge on this forum.
Td
 
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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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