Proliferative retinopathy and mounjaro

[wispadreams]

I have type 2 diabetes and have struggled with control of my blood sugar levels for several years with my annual hba1c being the following 2023 - 123, 2024 - 91 and 2025 - 68. I am also overweight at 14stone, 5ft 3 and 50yrs old.

Over the years I have tried what feels like a gazillion combinations of diets and medication but really struggled to find anything that worked. I'm an educated woman but just couldn't get the levels (or weight) down.

In the last year, I started mounjaro (which frustratingly has not made any difference to weight) and gliclizide, my sugars with finger prick test are now usually around 5 to 6 mmol, so so much better. I have also had zero side effects from mounjaro (7.5) since the start, aside from my blood sugars levels and the thought of fizzy juice making me feel ill.

However, my recent retinopathy screening has shown I now have proliferative retinopathy and I have a hospital appointment soon. Last years retinopathy was clear. As both mounjaro and gliclizide have potential hypo side effects, and, my sugars have "normalised" very quickly, im guessing its the sudden change that has caused this non reversible condition. I am gutted. I am scared, I live alone and have no real support network. I use computers daily for work and I live rurally so need to drive to simply live.

I think I have been in total denial about my diabetes if I'm honest, for the best part of 15 years where I have only required meds in the last 3 (according to Dr's).

While I don't blame mounjaro for this eye condition, I wish I had the weight loss side too to help me keep things stable as I age. Any tips?

 

[Leadinglights]

I have type 2 diabetes and have struggled with control of my blood sugar levels for several years with my annual hba1c being the following 2023 - 123, 2024 - 91 and 2025 - 68. I am also overweight at 14stone, 5ft 3 and 50yrs old.

Over the years I have tried what feels like a gazillion combinations of diets and medication but really struggled to find anything that worked. I'm an educated woman but just couldn't get the levels (or weight) down.

In the last year, I started mounjaro (which frustratingly has not made any difference to weight) and gliclizide, my sugars with finger prick test are now usually around 5 to 6 mmol, so so much better. I have also had zero side effects from mounjaro (7.5) since the start, aside from my blood sugars levels and the thought of fizzy juice making me feel ill.

However, my recent retinopathy screening has shown I now have proliferative retinopathy and I have a hospital appointment soon. Last years retinopathy was clear. As both mounjaro and gliclizide have potential hypo side effects, and, my sugars have "normalised" very quickly, im guessing its the sudden change that has caused this non reversible condition. I am gutted. I am scared, I live alone and have no real support network. I use computers daily for work and I live rurally so need to drive to simply live.

I think I have been in total denial about my diabetes if I'm honest, for the best part of 15 years where I have only required meds in the last 3 (according to Dr's).

While I don't blame mounjaro for this eye condition, I wish I had the weight loss side too to help me keep things stable as I age. Any tips?

OK ignore the question in your other thread. But you may find this link helps with some ideas for a dietary approcah which is more sustainable. https://lowcarbfreshwell.com/

 

[everydayupsanddowns]

Welcome to the forum @wispadreams

So sorry to hear about your retinopathy

But huge congratulations on the improvements in your BG levels - and really pleased you’ve found a combination of meds that is working so well for you. Shame it hasn’t contributed much to weight loss yet - but hopefully that might happen in time.

There is a form ‘early worsening’ retinopathy which can occur as a result of rapid improvements in BG levels over a short space of time. Where reducing levels which have been running high for some time to being in-range, can trigger changes in the eyes, some of which may improve in time. I’m not sure if this may be part of the picture for you? But hopefully your retinopathy might stabilise and even perhaps improve a lttle as your BG levels settle-in to being more in-range in the longer term?

I found this review which explores some of the mechanisms, and quotes results from some studies including the ‘Kroc’ collaboration

• No lasting damage results from the initial DR flare in some type 2 diabetes patients with mild‐to‐moderate DR…

And UKPDS

• and by 9 years there was a sustained significant protective effect of improved control.10 The long‐term risk reduction of DR progression was significantly better in intensively (23.0%) vs conventionally (27.8%) treated patients after 6 years of follow‐up

My takeaway is that despite the possibility of ‘early worsening’ which may result from rapid BG improvement, in the long term the improved BG management has a positive and protective effect.

Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review - PMC

Worsening of diabetic retinopathy (DR) is associated with the initiation of effective treatment of glycaemia in some patients with diabetes. It has been associated with risk factors such as poor blood‐glucose control and hypertension, and it ...

pmc.ncbi.nlm.nih.gov

We also have members who have successfully had laser surgery to help manage their retinopathy, so there are options available which can help protect your sight long-term.

 

[Flower]

Hi and welcome @wispadreams

I’m so sorry to hear about your retinopathy diagnosis, it is such a frightening thing to face. Sometimes with diabetes you really don’t know what to do for the best but getting your glucose levels as in range & as stable ongoing plus managing cholesterol & blood pressure are the best approach for limiting sight complications & slowing progression. Hopefully the Mounjaro will start to work for you in time, can the dose be changed?

It is so perverse that rapid improvement in glucose levels can speed up retinopathy progression. It should be the opposite but don’t despair although it is hard not to panic. Your retinopathy has been diagnosed thanks to retinal screening and the hospital will advise you on the best way to keep things stable and any treatment if it is needed. Should you need treatment there is a lot that can be done- laser and/ or injections until you actually notice any change or reduction in your vision. It isn’t a cliff edge.

This is useful information about all things retinopathy from Diabetes UK

Diabetic retinopathy — diabetes and eye problems

What is diabetic retinopathy? Diabetic retinopathy is a complication of diabetes. Sometimes called diabetic eye disease, it occurs when high blood sugar levels damage the retina at the back of your eye. This is the seeing part of your eye. If you don’t get this eye problem treated in time, it...

www.diabetes.org.uk

I hope you get good news that things are stable in your eyes at your appointment. Best wishes