Smoking Increases Diabetic Retinol Damage

Eye care professionals play an important role in the health of their diabetic patients.  By catching things early and counseling them on the negative effects of smoking, they can help patients reduce their risks of retinal damage (and vision loss) due to Type I Diabetes.  “Smoking” includes cigarettes, smokeless tobacco, electronic cigarettes, or smoking cessation products that contain nicotine.

According to researchers, nicotine can increase the risk of diabetic damage inside the eyes particularly in those who have Type I Diabetes. “Nicotine alone has been shown to promote pathological effects on the retinal pigment epithelium, photoreceptors and cells in the outer nuclear layer in mice. Chronic nicotine toxicity has also been shown to increase the severity of induced choroidal neovascularization, diabetic nephropathy and cataract development in multiple experimental rodent models.”

Moreover, the National Institute of Health (NIH), “diabetic retinopathy, the most common form of diabetic eye disease, is the leading cause of blindness in adults ages 20–74. It occurs when diabetes damages blood vessels in the retina [and] it affects 7.7 million Americans. That number is projected to increase to more than 14.6 million people by 2030. The longer a person has diabetes, the greater the risk for diabetic eye disease [and] once vision is lost, it often cannot be restored.”

The CDC says that one of the reasons why smokers can suffer from more diabetic complications than non-smokers is because “nicotine increases blood sugar levels and makes them harder to handle. People with diabetes who smoke often need larger doses of insulin to keep their blood sugar close to their target levels.

Recent studies have shown that OCT (Optical Coherence Tomography) may be helpful in detecting neuronal loss in the retina due to diabetes even before signs of retinal blood vessel damage or oxygen deprivation appear. “Although vascular complications (changes to the blood vessels) are typically seen as a hallmark of the disease, the functional deficits often precede the breakdown of the blood-retina barrier, suggesting an early neurodegenerative component.”

In addition to asking about a patient’s HbA1c number and performing a dilated eye exam, eye care professionals will also perform OCT routinely on diabetic patients to check for GCL (ganglion cell layer) loss and for changes in TRT (total retinal thickness) which may be indicative of early diabetic changes in the retina.

Smoking is harmful to all organs of the body, not just the eye.  The heart, lungs, and nervous system are all negatively impacted.  Eye doctors need to encourage even small changes for the improvement of overall health of their patient with the end goal of quitting nicotine entirely.

photo credit:  Michelle King- Unsplash 


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