early retinopathy and morbid obesity
- female 1960, diabetic 2001, morbid obesity
- 2012 Jan HbA1c 13%
- 2012 July HbA1c 8.5% and dropping;
- left laser, more macular central..next?
2012 more macular oedema (OCT below)
2011 early retinopathy
Vision remains good but the oedema has increased. The leakage is too central for effective laser. See graph: enlarge
- The oedema has increased despite the great improvement in diabetic control (HbA1c as above). Good control may help in the long term, but may make the retinopathy worse in the short term.
- At this stage the prognosis in uncertain...it may get a lot worse.
- To prevent such problems, the NHS needs to porvide more effective treatment
- prevention obesity (exercise/healthy diet)
- treatment for the obesity, support in the early stages (advice, nursing support)
- for morbid obesity bariatric surgery fobefore diabetic complications
- Show patients their retinopathy photo..a good motivational step.
- Avastin would be helpful here, especially if the vision becomes reduces.
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