Consultation with ophthalmologist, type 2, insulin user ...what you need to do to stop the retinopathy progressing

Your retinopathy

 

Laser / Avastin / is needed   

   

Prognosis

Laser and good diabetic control improve the prognosis. At present:

   this risk is 


Medical treatment

Your ophthalmologist has beed advised by the specialist diabetes team.Here are some ideas that need to be discussed with your diabetes nurse /doctor.

Diabetes education

The XPERT program for insulin users is recommended to help people control their diabetes.

Patients with major problems need a period of intensive support (NICE recommendations). This really means 1-2 weekly visits to your doctor/nurse, gradually learning what changes to make to your diet etc. If your doctor/nurse cannot provide this, the Community Diabetic Team (BCHT) can provide this. When controlled, 3 monthly checks are sufficient.

Smoking: 20 day = 400% more retinopathy

      

Ideas to improve glucose control

Sometimes extra drugs may be helpful. Exenatide or Victoza (they are injections & can help if kidneys good). But often insulin doses/glucose levels need to me more carefully controlled. It appears from the eye clinic that you may need to:

Blood pressure ideas:

Your systolic BP is        Target 130 systolic in clinic, 120 at home. Sometimes 5 different drugs are needed: See your doctor every 2 weeks, adding the extra drugs until the target pressure is reached, or until side effects develop.

Mental health

You seem to have

Weight

Reducing your insulin dose reduces your weight (but causes complications) and vice versa, so weight control is part of diabetic care. Your weight is  . Obviously if you eat less you will need less insulin, so if you reduce your calories you will need to reduce your insulin dose. You need to

Your exercise

2 hours/day if overweight

Good control can be achieved

There are clinics around the world where nearly all the patients have good diabetic control. This is achieved by having intensive support available when needed, and regular contact with professionals. This level of care of care is often not available in the UK, and so you have to do a lot more on your own initiative.

Ideas..ophthalmologists comments

 

 text for pasting    type2 no insulin  type 2 insulin  type 1 home
Birmingham Community Health Care NHS Trust (BCHT) organises the DAFNE & XPERT programs, intensive diabetic care, and GP training and support in diabetes care.