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Have You Been Diagnosed With Diabetic Retinopathy?

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Science-based Checklist to Minimize Risk of Blindness from Diabetes

If you have been diagnosed with diabetes, the goal is to avoid severe eye damage that would require destructive laser treatments to retina or a series of injections into the eye.

  1. Get a dilated eye exam with Dr. Belill soon after initial diagnosis and then every year, regardless of symptoms. He will test for all types of diabetic eye disease: retinopathy, macular edema, glaucoma, cataracts, dry eye, retinal vascular occlusions, ischemic optic nerve disease, & cranial nerve palsies. A report will be sent to your diabetes physician. If you have sight-threatening retinopathy, a referral will be made to a retinal specialist physician. Early detection of diabetic eye disease = early treatment = reduced risk of blindness.
  2. Take Eyepromise DVS nutritional supplement – 2 capsules daily with meals (available from our office or through
  3. If you are diagnosed with mild diabetic retinopathy or macular edema, take Pycnogenol® 100mg once daily and Benfotiamine 150mg three times daily with meals. Also ask your doctor about taking a medication called fenofibrate, which has been shown to reduce the likelihood of severe eye damage from diabetes in several large studies.
  4. Get between 7-8 hours of sleep each night (insulin sensitivity worsens when humans are sleep deprived). If your neck size is > 17 inches, snore, experience daytime drowsiness, morning headaches or someone observes that you stop breathing during sleep - then ask your diabetes doctor to order a sleep study test to rule out apnea. Treatment of obstructive sleep apnea can lower long-term risk of blindness and death.
  5. Wear BluTech® lenses that block ultraviolet (UV) and high energy blue light when exposed to sunlight and during the evening while indoors. This protects the retina, helps regulates sleep cycle, plus lowers risk of obesity and cancer. Some apps reduce high energy blue light in the evenings. For PC monitors: download app from For Apple devices: select “Night Shift” in display settings
  6. Get tested for nutritional deficiencies of Vitamin D, Vitamin B-12, and Macular Pigments (Zeaxanthin and Lutein). Eyepromise DVS formula can help in achieving healthy levels of these micronutrients plus many others.
  7. Take omega 3 fish oil daily with total EPA + DPA = 2000mg.
  8. Establish a balance of medication, nutrition, and daily physical activity to keep your A1c consistently under 6.5%, fasting blood glucose <110 mg/dl, 2-hour posting eating blood sugar <150mg/dl, blood pressure <130/80, LDL-cholesterol <100mg/dl, and triglycerides <150 mg/dl. (Individual goals may be less stringent for elderly and those with vascular complications – ask physician).
  9. Take your prescribed diabetes medications, on time, every time.
  10. Meet with a Certified Diabetes Educator (registered dietician or nurse) to develop optimal self-management skills. Ask your doctor to order diabetes education courses through a hospital (local contact info: Hurley 810-262-2310, Genesys 810-606-7747, Covenant 989-583-5190).
  11. Don’t smoke – besides increasing risk of diabetic eye disease, smoking is also a leading cause of permanent vision loss macular degeneration and glaucoma (not to mention lung disease and cancer).
  12. Chill out! Drink a glass of ice water upon awakening. Take cold showers for at least 10 minutes. Keep thermostat below 69°F. Studies show that this helps convert “bad” white fat to “good” brown fat, which can help with weight loss.
  13. Aim for 30 minutes of moderate intensity physical activity each day in consultation with your healthcare team. Include both aerobic and strength training. If overweight, increase to 60 minutes per day and have a goal to reduce body weight by 5-10%. Think of non-food rewards to give yourself.
  14. Get a Fitbit® pedometer to document 8-10 thousand steps walked each day. Consider yoga or tai chi classes. Fitstar® is a great personal trainer app for use with PC, Apple or Android devices. Get an exercise buddy.
  15. Join a community group that is dedicated to a healthy lifestyle for emotional support and motivation. Ask your health care team for help if you ever feel overwhelmed. Self-management of diabetes is a lifelong commitment that has many challenges. You are not alone! Visit
  16. Eat a low glycemic index, a plant-based diet that contains a variety of vegetables and whole fruits (not fruit juices). Talk to a dietician about top-rated diabetes diet plans: DASH, Mediterranean-style, Dr. Weil’s anti-inflammatory, Ornish, Paleolithic, and Alternate Daily Fasting.
  17. Substitute water or unsweetened tea for soda pop.  Drink black coffee.
  18. Eat ½ cup of fresh or frozen berries and drink 3 ounces of 100% pomegranate juice each day. Include a handful of nuts daily, and cold water fatty fish (wild salmon or sardines) at least twice/week. Increase daily fiber intake to at least 25 grams.
  19. Minimize saturated fats (red meat, cheese) and all trans fats (all packaged foods containing “hydrogenated” oils”). Minimize “white” foods like bread, rice, potatoes & pasta. Keep added sugars to less than 25 grams daily.
  20. Limit consumption of packaged snack foods (crackers, cookies, even “sugar-free” snacks) that contain lots of refined carbohydrates. Avoid foods or beverages sweetened with high fructose corn syrup.
  1. Do not skip breakfast. Eat smaller, more frequent meals to prevent blood sugar spikes. Do not let your blood sugar levels remain above 180 mg/dl for more than a few consecutive hours, as this results in ongoing damage even after blood sugars return to normal range.
  1. Make sure vegetables fill at least half of your plate at meals.
  1. Eat smaller portion sizes and try to limit total carbohydrate content of any big meal to 30 grams or less (look at food label to determine).
  1. Try taking 2 TBSP of apple cider vinegar before meals to limit post-meal blood sugar levels. Rinse mouth with water after to protect teeth.
  1. Eat more slowly. This gives your stomach times to feel full without over-eating; try putting your utensil down while you chew your food and don’t pick it back up until you have thoroughly chewed and swallowed.
  1. If you have read this information all the way to the end, give Dr. Belill a high five at next visit.