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Nutritional Management of Diabetic Retinopathy

Author: Dr. Joseph M. Freedman - Optometrist

Diabetic retinopathy is the leading cause of blindness in the United States. Fortunately, diabetic retinopathy is a nutritionally responsive disorder - in both the background and proliferative stages. This means that patients don't have to wait for the other shoe to drop. By integrating the complimentary strategies in this article, you can substantially reduce your risk of blood vessel damage to the retina.

Because diabetic retinopathy is brought on by high insulin and glucose levels that are associated with accelerated free radical production, the following natural agents can be used to reduce the initial damage to the blood vessels in the retina and enhance integrity:

Vitamin C

Vitamin C is probably the simplest and cheapest way to combat this aspect of the disease. It's essential in the synthesis of collagen, and it helps maintain capillary strength and resistance to fluid leakage. The vitamin C deficiency disease, scurvy, illustrates this. In the 1800s, British sailors on long sea voyages developed scurvy. They had bleeding gums because their blood vessels were fragile, and their capillaries deteriorated.


Bioflavonoids are associated with the protection and restoration of capillary function. They reduce blood vessel permeability and fluid leakage.

In diabetic patients, the sugar sorbitol may be deposited in eye tissues, resulting in cataracts, vascular dysfunction and neuropathy. Researchers have long been on a quest for a pharmaceutical agent that could act as an aldose reductase inhibitor and prevent the conversion of glucose to sorbitol. In fact, one already exists: the bioflavonoid quercetin. It's found in the skins of onions, garlic and apples, and it's available as a supplement.


Bilberry contains a class of bioflavonoids called anthocyanosides, which are known for reducing capillary discharge, improving night vision and reducing glare by accelerating rhodopsin regeneration and inhibiting its bleaching. Diabetics who take bilberry supplements experience less retinal bleeding.

Ginkgo Biloba

German researchers discovered that ginkgo biloba is helpful in treating chronic cerebral retinal insufficiency syndrome, which causes vision loss in elderly patients.

They've also found that ginkgo biloba improves vision in patients with other blood vessel related eye diseases. United States researchers believe that ginkgo improves memory in some patients with Alzheimer's and cognitive dysfunction, suggesting that it increases blood flow to the brain and may combat vascular eye disease.

Because of ginkgo's tendency to diminish platelet aggregation and thin the blood, exercise caution when recommending this herb to patients taking coumadin or those who have low platelet levels.

Alpha-Lipoic Acid

This naturally occurring antioxidant lowers blood sugar and protects the blood vessel wall from free radical assault. Credible research has documented that alpha-lipoic acid, which regenerates levels of other antioxidants like vitamin E and glutathione, is essential in supporting nerve function and preventing the cellular injury that leads to diabetic neuropathy.

A Final Word

No doubt, you've noticed that the holistic approach is becoming mainstream. Many doctors are incorporating nutritional strategies into their practice, and patient interest is increasing.

Of course, we don't all have to become nutritionists. But as doctors, we should be aware of the scientific database that exists on nutrition and understand how to use it to benefit patients' general and visual health.

Dr. Freedman, a nutritionally oriented optometrist and is a consultant to the nutrition and pharmaceutical industries.


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