Diabetes is a major public health concern and according to the Health Minister of Malaysia, Datuk Seri Dr. Dzulkefly (as of March 2019) around 3.6 million Malaysians are currently suffering from diabetes. It is projected that there will be seven million Malaysian adults with diabetes by 2025 which is a very worrying trend. Most of us are aware of how diabetes can impact our health but did you know that it can also affect the health of our eyes?
We spoke to Pharmacist at WellBeing Pharmacy, Tan Hui En on diabetes and how it can affect our eye health.
1Twenty80: What is your opinion on diabetes in Malaysia?
Tan Hui En: Malaysia has the highest rate of diabetes in Asia and probably one of the highest in the world. I think we should take this data very seriously and do something including education on leading a healthy lifestyle and campaigns to slow down this impact. We should be concerned about the increasing trend in diabetes rates as it impacts our government due to its significant cost, which took up to RM 2 billion (as of 2011, based on a microeconomic study), and the cost shoots up to RM 3.52 billion if societal costs were included.
1Twenty80: Why do you think that the rates are so high?
Hui En: This increasing trend is mainly due to factors such as obesity and physical inactivity. Most working adults are found to spend most of their time at work. More health-related campaigns should be launched in collaboration with employers so that health-related issues can be resolved more practically. Another factor is diet. Malaysia has diverse food options due to its rich culture and it’s easily found throughout the day even during midnight such as at mamak stalls. Local food such as nasi lemak, roti canai and teh tarik have been shown to significantly increase blood sugar and also cause obesity without proper control of food intake.
Some diabetic patients choose not to take medications or take them irregularly despite being diagnosed as a diabetic because they are afraid of the side effects of the medication. Proper education by healthcare providers is needed to make sure the patient understands the benefit-risk ratio of why they need the medication. Education needs to be aimed at the youth too as the disease is now impacting young people.
Quotes: Local food such as nasi lemak, roti canai and teh tarik have been shown to significantly increase blood sugar and also cause obesity without proper control of food intake. 
1Twenty80: What are other ways that diabetes can negatively affect our health?
Hui En: It can affect our three major organs which are the eyes, heart and kidney. I would suggest my diabetic customers to have an eyesight and blood test once every three to six months to confirm the health status of these organs.
Additionally, it is very important to take care of any wounds found on the limbs, as diabetic patients usually have slow recovery rate and need to take extra care by washing wounds with proper wound care solution and apply the correct cream.
1Twenty80: In what way can diabetes affect a patient’s vision?
Hui En: Prolonged high blood glucose level can weaken and damage small blood vessels within the retina. This may cause swelling and bleeding (hemorrhages) inside of the retina.
They will start to develop blurry vision and feel dizzy. Usually, diabetic patients will feel numbness easily too, so I always advise them to take nerve-related supplements which contains Vitamin B1, B6 and B12 and also ALA (Alpha Lipoic Acid) to protect their nerves.
Quotes: We only have one pair of eyes, and so I urge every one of us to take good care of them as we will use them for life!
1Twenty80: Can this disease be reversed or is it possible to stop its progression?
Hui En: At the early stage, it might be easier to stop the progression by consistently consuming diabetic medicine (to have well-controlled diabetes), taking supplements or proper eye care. I would suggest my diabetic customers to have their blood sugar checked regularly so that their treatment is on point and also consume eye supplements on a regular basis too. This is because the diet of most people nowadays is imbalanced. By taking supplements, we could ensure that our body gets the basic essential nutrients for healthy organ repair and maintenance. Last but not least, eye treatment needs to be started as soon as any eye disease is diagnosed, so that the disease progression could be slowed down or even better, reversed to a healthy state.
1Twenty80: How can a pharmacist such as yourself help someone who has diabetic retinopathy?
Hui En: After working in retail pharmacy for a few years, I recognise that we as pharmacists, play a very crucial role in promoting healthy eye care to diabetic patients as we are usually the first place they seek advice when they are facing health issues. As a healthcare provider, my pharmacy usually organises free glucose and eye test campaign for my customers so that they can get their blood sugar level/eye health checked regularly.
I would usually advise them to take extra note of dry eye symptoms. First, when experiencing dry eye symptoms, I would advise them to use eye drops to treat the symptoms. Secondly, I would advise them to take eye supplements so that their eyes would have the correct ratio of nutrients to obtain maximal eye health. Last but not least, I would advise all my diabetic patients to exercise regularly, at least three to four times a week and at least 30 minutes each time.
1Twenty80: What is your advice to a diabetic be on their eye health?
Hui En: Take your diabetes medication regularly and do not stop taking medication without instruction from your doctor. Check your blood sugar regularly at least three times a week to see if your diet and medication is able to control blood sugar levels. Intake of food rich in Vitamin A is essential to maintain eye health. A balanced diet is not easy to acquire nowadays due to the lure of fast food, so I strongly recommend to those who wish to look for eye health protection to take high quality eye supplements on a regular basis, to build your base line protection to prevent something worse from happening.
Also, proper eye rest is important. Regardless of whether you’re a student or working adult, looking at the computer screen or phone screen is inevitable. Taking a five to 10-minute break from your screen at least every half an hour is needed to make sure our eyes are not exposed to too much harmful rays emitted by the screen. Also, by looking at green subjects regularly would help too. Another clearly seen phenomenon nowadays would be playing on the phone too much, it is very important to educate them not to look at the phone at low light condition, especially in bed after switching off the bedroom light. This will cause extreme harm to the eye and damage is usually irreversible. We only have one pair of eyes, and so I urge every one of us to take good care of them as we will use them for life!
