Risk Factors

Uncontrollable

Duration of diabetes: The duration of diabetes is the strongest risk factor for developing retinopathy¹. This means that it is very important to keep getting regular eye checks, even if all previous checks have been clear.
Ethnicity: Aboriginal and Torres Strait Islander Australians are two to four times more likely than the general population to develop diabetes and are therefore at a much higher risk of developing vision problems related to diabetes¹. Other groups including some Middle Eastern and Asian populations and Pacific Islanders are also at higher risk.
Genetics: Studies have found that many genetic factors can influence the onset of complications in diabetes, including the severity and speedof onset of diabetic retinopathy¹.
Medical history: Women who have previously been diagnosed with gestational diabetes (or a condition known as polycystic ovary syndrome) are at increased risk of developing type 2 diabetes¹, and hence retinopathy, later in life.

Controllable

High blood glucose: People who have persistently high blood glucose levels are at risk of serious vision loss and blindness.

· Regular follow-ups with healthcare professionals are essential to help preserve vision. People with diabetes whose blood glucose is not at target levels are almost eight times more likely to develop diabetic retinopathy.

· It important to speak to the GP or diabetes specialist about personal target blood glucose range, which can depend on age, medical condition and other risk factors.

· If there is already some degree of diabetic retinopathy, the goal is to get glycated haemoglobin (HbA1c) level to 7% or less (53 mmol/mol)¹.

· (HbA1c is a measure of the blood glucose control over the preceding few months. Note that the HbA1c target is different to the target for blood glucose at any particular time). A periodic test of HbA1c is therefore recommended.

· For some people, continuous blood glucose monitoring may be recommended. Guidance should be sought from a diabetes specialist.
High blood pressure: People with diabetes and high blood pressure are not only more likely to develop diabetic retinopathy but it will also progress more rapidly. It will also aggravate any macular edema (fluid leakage)

· If there is already some degree of diabetic retinopathy, the aim should be to get systolic blood pressure (the bigger number) to 130 mm Hg or less¹.
Blood lipids:

People with abnormal blood lipids are at greater risk of developing diabetic retinopathy.

· Get blood lipids to normal levels.

· Guidance should be sought from a GP or diabetes specialist.
Weight and exercise: People who carry excess weight, especially around the waist, are at substantially increased risk of their diabetes progressing.

Regular exercise helps insulin to work better, lowers blood pressure, helps reduce weight and reduces stress. A relatively small weight loss of even

5 to 10% of current weight can result in a significant reduction of risk.

· Incorporate exercise into a daily routine.

· Discuss any planned changes in diet or exercise program with a GP or diabetes specialist.

· A Credentialled Diabetes Educator™/diabetes educator can support the increase of exercise into daily routine.
Smoking: Smoking significantly increases the risk of diabetes and its related conditions. It also increases blood pressure and blood sugarlevels, making it harder to control diabetes.