What It Means to Develop Diabetic Macular Edema Early

You may think diabetic macular edema (DME) affects older people only. But, the truth is, the eye condition can develop in anyone with type 1 or type 2 diabetes.

DME is more common in people with type 2 diabetes, which is on the rise in young people (ages 20 and younger), according to the Centers for Disease Control and Prevention (CDC). And, as the rate increases, so does the number of people being diagnosed with DME at a younger age — in their 40s and 50s instead of their 60s.

“As more people develop type 2 diabetes due to obesity and related issues, DME risk rises,” notes Judy Kim, MD, an ophthalmologist who specializes in diabetic eye diseases. One study found that 1 in 25 people with diabetes who are 40 or older have DME in at least one eye.

If you were recently diagnosed with DME, you probably have lots of questions. Here’s everything you need to know about this eye condition.

Why DME May Affect Younger People

Early development of diabetes isn’t the only reason people are getting DME younger. It’s also because more people are being diagnosed with type 2 diabetes specifically. Unlike type 1 diabetes, type 2 gradually robs the hormone insulin of its ability to manage rising blood sugar levels that can damage the retinas, leading to a higher chance of DME developing.

Some clinicians believe younger people may be anatomically prone to DME. “Their vitreous gel — the fluid within the eye — is more formed and better attached to the retina, which allows it to cause traction on already leaky blood vessels in the macular region. This can create further damage to their vision,” says ophthalmologist Rajeev Ramchandran, MD, an associate professor of ophthalmology at the University of Rochester Flaum Eye Institute in New York.

Signs of DM to Watch For

Because symptoms are slow to develop, DME can go unrecognized for years. “Early diabetic retinopathies (retinal diseases) have no symptoms,” says Dr. Kim. “By the time people notice vision changes, the condition can be advanced and difficult to treat.”

According to Cleveland Clinic, symptoms of DME may include:

• Blurred vision
• Double vision
• Difficulty reading
• Floaters (tiny dots “swimming” before your eyes)
• Dulled vision (muted and less vivid colors)

If DME is left untreated, vision loss can occur. Research shows that up to 30 percent of people with untreated DME will lose the ability to see at least three lines of letters on a standard eye chart within three years.

That’s why it’s important to take diabetes management and eye screenings seriously. If you have diabetes, you should have your eyes checked at least once a year, starting 3 to 4 years after being diagnosed.

How to Prevent or Slow the Progression of DME-Related Vision Loss

Properly treating diabetes is the key to preventing or slowing the progression of DME. In addition to any treatments or medications prescribed by your doctor, consider the following for managing both conditions:

• Monitor your blood sugar levels. Managing A1C levels is the gold standard of keeping diabetes under control.
• Keep your blood pressure and cholesterol in check. Similar to managing blood sugar levels, it’s also important to monitor blood pressure (a good number is around 120/80) and keep your overall cholesterol under 150.
• Stick to a balanced diet. What you eat plays a part in keeping your blood sugar, blood pressure, and cholesterol levels stable. Be sure to incorporate nonstarchy vegetables, such as broccoli and spinach, that are high in fiber and vitamins; whole foods (beans, nuts, oats); and fruits into your daily meal plan.
• Exercise regularly. The CDC recommends 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous physical activity weekly.
• Stop smoking. If you smoke, do your best to quit. Nicotine changes the way your cells respond to insulin, which can result in blood sugar spikes.

Planning Ahead: What to Ask Your Doctor

If caught and treated early, DME-related vision loss can be stopped or slowed down. At your next doctor’s appointment, be prepared to discuss how to best treat your DME. Consider asking about:

• Treatment options and their potential timelines
• Lifestyle changes or activities
• Preexisting conditions or prescriptions that could affect DME
• Activities to avoid or alter
• When to seek immediate medical attention