Serious EYE problems and NEW case of Diabeties POST Gastric By Pass

I just meet with a leading Endocronologist at one of the nations MAJOR Diabetic research centers. As it also happen this MD is also an expert on Obesity..... He told me that he is seeing AN INCREASE IN FOLKS POST GASTRIC BYPASS DEVELOPING DIABETIES.... Since my bypass 2 years ago... My BGL levels are in better control ........... BUT AS A RESULT OF Sudden and DRASTIC changes in them.. I have developed a serious complicatin of Macula edema and retionpothy...... It seems that the drastic changes can cause complications as easily as having too high BGLs. (something to do with hemostasis!) In an otner week I will have a 3rd Laser surgery to try to reduce the macula in one eye. HOWEVER the loss of vision that has occourred over the past year is permenat. Please make sure you get a dialted eye exam and make sure your eye MD knows of any changes in your vision ASAP. ESP any central blurrines, as well as seing stright lines as wavy. I have had eye exams every year and these changes happened very quickly. .

Thanks for the heads up. I just had my annual eye exam. I waited just a bit so it would be closer to any WLS I might have. He said he wanted to see me back in 8 months. That would make it approximately 6 months after any surgery. Now I can see why he wanted another exam before my 1 year period. Thanks for all the information you have provided.

I had macular edema and retinapathy prior to WLS. It was so bad that I had 5 laser surgeries on my right eye and 4 on my left. I had to have an additiional surgery on my right eye called a Vitrectomy where I was hospitalized overnight and they removed scare tissue and the vitreous from my eye. Since my WLS everything is GREAT. I see my Retinologist every 6 months and he is thrilled that my BGL are in better control and that my need for insulin is greatly reduced. I haven't needed a laser in over 2 years and I hope never again.

Sorry to hear that you are having eye problems. My story is much the same, only the problems happened before wls. I had a stroke Nov '04 -- at which time I was diagnosed type 2 diabetic (probably very long-standing -- A1C of 13). I had retinal photographs,etc.....they showed absolutely no damage in my eyes. By 6 months later, with cholesterol, blood pressure and glucose under total control, I was in advanced stage 4 retinopathy. In a period of 10 weeks I had 5 hemorrhages in my left eye and developed macular edema and glaucoma in my right eye. After 5 laser surgeries and an Avastin injection things have improved a little....but I will agree -- this is no fun! Hope you hae no more problems.....

Reversion of 'early worsening' of diabetic retinopathy by deliberate restoration of poor metabolic control. Chantelau E, Meyer-Schwickerath R. Diabetesambulanz MNR-Klinik, Heinrich Heine University, Dusseldorf, Germany. Acutely lowering long-standing severe hyperglycaemia can trigger progression ('early worsening') of diabetic retinopathy, most likely by up-regulation of the circulating insulin-like growth factor 1 (IGF-1). This condition, also called 'florid retinopathy', rarely responds to standard laser coagulation treatment. In this retrospective report, 2 young patients with type 2 diabetes are described, in whom deliberate restoration of poor diabetes control reduced the serum IGF-1 levels and improved 'early worsened' diabetic retinopathy. Copyright 2003 S. Karger AG, Basel Publication Types: Case Reports PMID: 12913330 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12913330&dopt=Abstract ________________________________ Does Initiating Intensive Glucose Control Worsen Existing Diabetic Retinopathy? Question Some endocrinologists in Japan state that controlling blood glucose levels too quickly in patients with severe diabetic retinopathy can worsen retinal lesions. Is there any evidence to support this statement? Response from Lloyd Paul Aiello, MD, PhD Assistant Director, Beetham Eye Institute, Joslin Diabetes Center; Associate Professor of Ophthalmology, Harvard Medical School, Boston, Massachusetts Jerry Cavallerano, OD, PhD Assistant to the Director, Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts The Diabetes Control and Complications Trial (DCCT) definitively demonstrated that intensive control of blood glucose levels in patients with type 1 diabetes mellitus substantially reduces the risk of onset and progression of diabetic retinopathy.[1,2] In addition, the reduced risks of onset and progression of retinopathy associated with intensive therapy persisted at least 4 years beyond the conclusion of the DCCT, despite near convergence of hemoglobin A1c levels in the intensive-therapy and conventional-therapy groups.[3] The United Kingdom Prospective Diabetes Study (UKPDS) found similar benefits of intensive blood glucose control for patients with newly diagnosed type 2 diabetes.[4] In the Kumamoto study in Japan of patients with type 2 diabetes who were taking insulin, the benefits of intensive control of blood glucose levels were likewise demonstrated.[5] The DCCT documented "early worsening" of diabetic retinopathy in the study population.[6] Early worsening of retinopathy was defined as a 3-step or more progression of retinopathy on the severity scale, the development of cotton wool spots and/or intraretinal microvascular abnormalities, and "clinically important retinopathy" if it occurred between baseline and the 12-month follow-up visit. Early worsening of retinopathy occurred in 13.1% of 711 patients assigned to intensive treatment and in 7.6% of 728 patients assigned to conventional treatment. Nevertheless, after 18 months this early worsening in retinopathy reversed, and patients in the intensive-treatment group fared better than those on conventional therapy. Risk factors for early worsening were higher hemoglobin A1c level at baseline and reduction of this level during the first 6 months following randomization. There was no evidence that a gradual reduction in A1c levels reduced the risk of early worsening. In the DCCT, the long-term benefits of intensive control clearly outweighed the risk of early worsening of retinopathy, and no case of early worsening resulted in serious visual loss. Based on these findings, it is recommended that persons with type 1 or type 2 diabetes initiate intensive therapy as early as possible, and maintain intensive therapy for as long as possible, with the expectation that intensive control of blood glucose levels will reduce the risk of onset and progression of diabetic retinopathy. For patients with elevated hemoglobin A1c levels, careful retinal evaluation, close retinal follow-up, and laser photocoagulation as indicated are important components of care as intensive therapy is initiated. Posted 05/02/2003 -------------------------------------------------------------------------------- References The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977-986. Abstract The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial. Arch Ophthalmol. 1995;113:36-51. Abstract Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. N Engl J Med. 2000;342:381-389. Abstract Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352:837-853. Abstract Shichiri M, Kishikawa H, Ohkubo Y, Wake N. Long-term results of the Kumamoto study on optimal diabetes control in type 2 diabetic patients. Diabetes Care. 2000;23(suppl 2):B21-B29. Abstract Early worsening of diabetic retinopathy in the Diabetes Control and Complications Trial. Arch Ophthalmol. 1998;116:874-886. Abstract