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Medically reviewed and verified by Kate Burke, MD, MHA
Diabetes and cataracts are two common health conditions that impact millions worldwide. Both can significantly affect a person’s quality of life! The data says that people with diabetes are about two to five times more likely to develop cataracts than those without. Your risk depends on how long you have had the condition, how often blood sugar levels are elevated, and whether you have a buildup of fluids in your cataracts called diabetic macular edema (DME). Here, PatientsLikeMe will explain the relationship between diabetes and cataracts and how high blood sugar contributes to cataract formation.
Diabetes and Cataracts
Diabetes is a chronic condition that affects how the body processes glucose (sugar) into energy. When blood sugar levels remain high for extended periods, it can damage any parts of the body, including the eyes. According to the American Diabetes Association, 38.4 million Americans had diabetes in 2021. That is about 12% of the total population, and they expect this number to rise.
Cataracts happen when the natural lens of the eye becomes cloudy, leading to blurry or hazy vision. While cataracts are typically associated with aging, diabetes can significantly accelerate their development. The National Eye Institute reports that over half of Americans aged 80 or older have cataracts or have undergone cataract surgery.
Diabetes and the Risk of Cataracts
High blood sugar does play a role in the formation of cataracts. There are two primary mechanisms behind this.
- Elevated Glucose Levels in the Eye: The aqueous humor is a clear fluid in the eye. It supplies oxygen and glucose to the lens. When blood sugar is poorly controlled, glucose levels in the aqueous humor rise. This leads to the buildup of sugar in the lens. In turn, this disrupts the lens’s normal structure and causes clouding.
- Excess Sorbitol in the Lens: High blood sugar triggers the production of sorbitol, a sugar alcohol, inside the lens. Sorbitol buildup can lead to something called osmotic stress. This then causes the lens to swell and further contributes to the formation of cataracts.
Diabetic Macular Edema
Diabetic macular edema (DME) is a complication of diabetic retinopathy, a condition where high blood sugar damages blood vessels in the retina. DME happens when fluid leaks into the macula, which is the part of the retina responsible for sharp central vision. This then causes swelling and vision problems. DME is one of the leading causes of vision loss in people with diabetes. It affects about 5.5% of people with diabetes, regardless of income level or geographic location. Controlling blood sugar is the best way to lower the risk of DME.
People with DME are at higher risk for cataracts because of the combined effects of diabetes and ongoing eye damage.
- Prolonged High Blood Sugar: People with DME often have a history of poorly controlled diabetes, which increases the likelihood of cataract formation.
- Compromised Eye Health: DME causes chronic inflammation and fluid buildup in the retina. These factors can exacerbate cataract development and complicate treatment.
- Surgical Risks: Cataract surgery in individuals with DME can lead to additional complications, such as worsening macular edema or diabetic retinopathy. Pre-existing eye conditions require careful management before, during, and after surgery.
Preventing Cataracts
Although cataracts cannot be entirely prevented, people with diabetes can take steps to reduce their risk. The first and most important thing is to control blood sugar levels. Monitor blood sugar regularly and aim for consistent levels within your target range. Make sure you follow your prescribed medication and insulin regimens. A healthy lifestyle can also make a huge difference! Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Exercise regularly to improve overall health and blood sugar control. Try to avoid smoking altogether and limit alcohol consumption.
Regular eye exams should be a part of your routine. Comprehensive eye exams help detect early signs of cataracts, diabetic retinopathy, or DME. Early intervention can prevent complications. Doctors use advanced diagnostic tools like optical coherence tomography (OCT) to monitor your eye health.
Cataract Surgery
When it comes to it, cataract surgery is a safe and effective way to restore vision. People with diabetes should take some special precautions.
- Optimize Blood Sugar Before Surgery: High blood sugar can delay healing and increase the risk of infection. Work with your healthcare team to stabilize blood sugar levels before surgery.
- Address DME and Retinopathy: Treating DME or diabetic retinopathy before cataract surgery can improve outcomes. Intravitreal injections or laser therapy may be recommended.
- Choose an Experienced Surgeon: Find a surgeon with expertise in managing diabetes-related eye conditions. They can tailor the surgical approach to minimize risks.
- Follow Post-Surgical Care Instructions: Use prescribed eye drops to reduce inflammation and prevent infection. Attend all follow-up appointments to monitor healing and manage potential complications.
There is no question that having diabetes increases your risk of developing cataracts. High blood sugar levels can cause a number of complications and making sure you have strategies in place to manage blood sugar is the best way to protect yourself long-term. A healthy lifestyle and regular eye exams can help keep your vision clear. If this is a concern for you, talk to your doctor today!
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