Vision

[pinnig]

Hello again
Since my double confession two weeks ago about not being very insulin compliant and a susequent hospital admission with DKA I have really screwed the nut. Low(ish) carb diet, strict administration of novorapid and lantus, walking 5k daily and I have mostly scored between 5 and 7 all day. Odd high, one low and generally feeling better for it. Still work in progress.

However, my vision is dreadful. No possibility of driving and I can't even see the telly clearly. Everything is really blurry and despite wearing specs most of my life (now varifocals) I can almost see better without then and that's never been 20/20.

I've had regular follow up with a DSN who has explained that high sugars has altered the shape of the lense, not to think about a change of prescription for at least three months as this will take some time until it settles. She thinks I have dropped my BG too quickly. I felt really deflated and that I couldn't do right for doing wrong.

I mostly work from home but do need to drive to an office a couple of times a week. I've been off recovering from the DKA but hoped to be back on Monday. Going anywhere and sitting in front of a laptop is presently beyond me. If I hang my phone from the end of my nose I can just about function hence why I've been able to post this.

Has anyone had a similar experience and how long did it take to see clearly again? I'm so keen to maintain good levels and physical and mental health but really feel flat.

As ever any advice would be much appreciated.

 

[Inka]

@pinnig My eyes were very blurry after diagnosis. I didn’t wear glasses so can’t comment on that but yes, it took 2 or 3 months to get back to normal. Stating the obvious here, but you shouldn’t drive if your vision is affected.

Bringing your sugars down too quickly can potentially cause damage, especially to the eyes. Maybe you could do it in stages?

 

[pinnig]

Don't worry I'm not driving!

That's not great news that my vision could take some considerable time to settle.

I'm not sure what to do really. If I should let my BG levels go back up to bring them down more gradually or just keep going as I am.

I did pose that question to the DSN but didn't get any real direction from her. Just a lot of hmmmming

 

[Inka]

Although my eyes did take those months to settle, I saw an improvement in weeks. I don’t remember exactly when as, tbh, it was the least of my worries, but it did ease over the months.

If I remember rightly you were quite high? I can only say what I’d do but I’d go for slightly above normal for a while then gradually lower them rather than risk any eye issues.

 

[stillgoing]

Hi. A difficult one. Having done so much work to get your BG into the very good I think I would be inclined to hold the level there and let the eyes catch up. I don't think your eyes will improve by raising the BG but will just be a matter of time to recover. Once your eyes have recovered you can then work on fine tuning slowly. Sorry you now have two opposite opinions. I think @Inka has direct experience of eye problems.

 

[Loobyloo]

I am now settling at 7 months. They were dreadful like you are explaining and i was dizzy and could go nowhere. They then settled better after diagnosis and Lchf diet and meds. But still kept changing. One minute long sighted then short sighted and was advised by optician to return after few months when things settle down. I am now thinking it pretty much settled so shall be making my appointment for a check up soon. In the mean time i bought cheap reading glasses from poundland or ebay to varying strengths as needed to get by and were invaluable, but no longer need.

 

[pinnig]

Thanks folks.
@Inka i was really high. Last hba1c was 127 and off the chart when admitted for DKA.
@stillgoing my gut says I've come this far so keep going but I've been very wrong before.
Looks like I may have come down too hard and fast. What to do, what to do.....

 

[Loobyloo]

Thanks folks.
@Inka i was really high. Last hba1c was 127 and off the chart when admitted for DKA.
@stillgoing my gut says I've come this far so keep going but I've been very wrong before.
Looks like I may have come down too hard and fast. What to do, what to do.....

As you can see i came down pretty fast from 108 to 40 as i wasn't aware that i should take slowly. My eyesight is pretty much normal now so hopefully no harm done. I do think it would be good idea for DN or Doctors to advise people about dropping too hard really if it can cause harm. I thought i was doing right thing as i am sure you did

 

[stillgoing]

I did say to hold where you are rather than keep going for now.

 

[AJLang]

Hi Pinnig I don’t comment on the forum very much nowadays, but I do when I think my advice will help. First of all congratulations with how well you’ve done. However with such a rapid drop in BG levels there is a risk of permanent eye damage from retinopathy/maculopathy and also losing hypo awareness. Although I can’t cite the sources I’ve read a lot about this over the years. However that doesn’t mean it has to happen - ideally you reduce your BG gradually, so my suggestion would be to run your levels slightly higher. I can’t give you medical advice but if I were for you I’d be aiming if for average BG of 7.5-9.0 for the moment - but this is not medical advice. Then gradually aiming for average of 7.5. Im not saying this what you should do, just what I would do with the benefit of almost 50 years of Type 1 diabetes. I hope this helps.

 

[pinnig]

@Loobyloo I too wish they had at least mentioned something. I've not been much a fan of the diabetic specialist staff (my GP and practice nurses are the exception) so perhaps I'm not surprised that lectures about highs aren't tempered with warnings about dropping too fast.
Two steps forward and three back...

 

[pinnig]

Hi Pinnig I don’t comment on the forum very much nowadays, but I do when I think my advice will help. First of all congratulations with how well you’ve done. However with such a rapid drop in BG levels there is a risk of permanent eye damage from retinopathy/maculopathy and also losing hypo awareness. Although I can’t cite the sources I’ve read a lot about this over the years. However that doesn’t mean it has to happen - ideally you reduce your BG gradually, so my suggestion would be to run your levels slightly higher. I can’t give you medical advice but if I were for you I’d be aiming if for average BG of 7.5-9.0 for the moment - but this is not medical advice. Then gradually aiming for average of 7.5. Im not saying this what you should do, just what I would do with the benefit of almost 50 years of Type 1 diabetes. I hope this helps.

It does. Many thanks

 

[pinnig]

I did say to hold where you are rather than keep going for now.

Apologies. I meant by 'keep going' as keep where I'm at now rather than going any lower. Think we are probably saying the same thing

 

[Inka]

Thanks folks.
@Inka i was really high. Last hba1c was 127 and off the chart when admitted for DKA.
@stillgoing my gut says I've come this far so keep going but I've been very wrong before.
Looks like I may have come down too hard and fast. What to do, what to do.....

Ok, so I’d aim higher than your final target range. @AJLang has given advice and has many more years of experience than me. I don’t know what the right range would be but your HbA1C gives an average blood sugar of 19 or so.

If it was me I’d go for a range with a high minimum and a maximum a few mmols below 19, then gradually lower the ends of the range. I’m guessing there’s no magic answer as a bit of luck is involved, but dropping too quickly can potentially cause damage.

@stillgoing I have no direct experience. I speak from what I’ve heard and read over the years with Type 1.

 

[Maca44]

My eyesight was really bad just before diagnostic and I mean bad, so spent £160 on new glasses so I could drive, which I do for a living, but a month later it began to blur again so off came the glasses and now it's perfect again and I have a nice pair of new useless glasses.

Your doing great don't worry you are doing amazingly well

 

[Becka]

As you can see i came down pretty fast from 108 to 40 as i wasn't aware that i should take slowly.

My reduction was not as quickly as yours, I was diagnosed at 11.2% (99) and three months later was down to 6.4% (46), so maybe it was not enough to be a problem. But no one said anything to me about either. It is only reading your comment that even made me consider that it may have been fast.

Mind, it would have taken a lot of effort not to have reduced so quickly as they were unsure of the type, did the tests, then put me on Gliclazide which did all the work

 

[stillgoing]

Although my eyes did take those months to settle, I saw an improvement in weeks. I don’t remember exactly when as, tbh, it was the least of my worries, but it did ease over the months.

I thought by your statement that you had suffered with eye problems.

I note that current voting seems to be 2 raise and 1 stay. This is from the T1s. The T2 seem to be saying they know the problem and wish you the best (which we all do) Your DSN seems to be sitting on the fence.

As a T1 with 57 years experience I know very little about T2 and nothing about eye conditions like yours so please feel free to ignore me. I won't be offended. Keep in touch and share your experience so you can answer the question with some authority and we can all continue learning.

 

[KARNAK]

Hello @pinnig I wasn`t told either about dropping too quickly, from HbA1c 156 to 48
in 3 months has left me with permanent painful Neuropathy (DPN). My eyes also
became very blurry but cleared up after about a month but I have had several issues
since with my eyes but they eventually return to some normality.

I agree with @AJLang raise your BGL`s slightly for a few weeks keeping them below
ten, this will also help you with hypo awareness then reduce them slowly to your very
good present levels.

 

[Loobyloo]

I wasn`t told either about dropping too quickly, from HbA1c 156 to 48
in 3 months has left me with permanent painful Neuropathy (DPN). My eyes also
became very blurry but cleared up after about a month but I have had several issues
since with my eyes but they eventually return to some normality.

This is alarming that Doctors or Nurses are not warning people of this and permanent damage occurring in some people. Hopefully some newbies will read these warnings by members and take things steadily. When i started out i thought dropping hard and fast was the best way to go and have received praise from my Doctor and nurse since for having drastic results. Now thinking it wasn't such a good idea after all but too late now. Sorry @KARNAK to hear you suffered neuropathy.

 

[Inka]

I thought by your statement that you had suffered with eye problems.

I note that current voting seems to be 2 raise and 1 stay. This is from the T1s. The T2 seem to be saying they know the problem and wish you the best (which we all do) Your DSN seems to be sitting on the fence.

As a T1 with 57 years experience I know very little about T2 and nothing about eye conditions like yours so please feel free to ignore me. I won't be offended. Keep in touch and share your experience so you can answer the question with some authority and we can all continue learning.

Yes - the blurriness which was the original question and which I mentioned in my first post referring to two or three months, and referred to again in my following post where I clarified that the blurriness had eased over that time 🙂 That blurriness is common and temporary.

There is also a second eye issue discussed above which is that a sudden drop in blood sugar can potentially carry a risk of causing retinopathy and macular oedema. Obviously more serious and a separate issue from temporary blurriness.