I was diagnosed with LADA back in May 2023. Since then, my A1C levels have stayed between 5.7 and 6.3, and my annual eye exams showed no issues until now. My most recent report indicates mild diabetic eye disease, though no intervention is required yet. The notice mentioned I should keep an eye on my cholesterol, blood pressure, and glucose levels, with a follow-up exam in a year. I don’t have issues with hypertension or cholesterol, and I really thought my blood sugar management was solid. My time in range is consistently above 70%, and my A1C has always been under the target of 7. I’m just caught off guard that there’s already damage despite keeping my numbers in check. I use a CGM, stay on top of my insulin, and always pre-bolus. Does anyone have advice or words of encouragement? Thanks.
Sometimes it just comes down to genetics; some people’s bodies are simply more vulnerable to damage, and for you, that might be your vision. While an A1C under 7 is a solid target, the truth is that level can still lead to complications for some. It’s possible some of this damage began before you were even diagnosed and is only now showing up on scans. It sounds like your medical team is being proactive with monitoring. Just keep focusing on your glucose levels and try to minimize those high readings. If you’re looking to improve your time in range, you might want to explore an insulin pump with a closed-loop system for more precise dosing.
How long has it been since your previous screening?
I suspect the issues with your eyes might not be from diabetes specifically, but perhaps related to blood pressure or another factor—kind of a “bad luck” situation. Try monitoring your blood pressure twice daily at the same times for a couple of weeks to see what your average looks like; the results might surprise you. I’m not a medical professional, so this is just a guess.
Do you experience significant spikes and crashes? It’s often those sharp rises that harm the blood vessels. It’s entirely possible to maintain a low A1C while still having frequent spikes.
Honestly, I wouldn’t panic. I was told I had background retinopathy (which didn’t affect my vision or require treatment) when I was 18, about five years post-diagnosis. I’m in my mid-30s now, and the condition hasn’t progressed at all. My optician mentioned that most people with diabetes will develop background retinopathy eventually. If your management is decent—and yours sounds better than most—it likely won’t ever reach a stage needing treatment. Just get your eyes checked every six months, and you’ll probably be fine. I totally get why you’re worried, though; I remember getting that letter and being terrified I’d lose my sight in a few years.