Diabetic macular edema (DME) is a complication of diabetes that causes fluid buildup in the part of the eye that controls clear, detailed vision. You can’t always prevent it, but managing blood sugar, cholesterol, and blood pressure—as well as screening for DME—can protect your vision.
Diabetes can affect a person’s eye health, sometimes culminating in DME. High blood sugar levels can form compounds that harm blood vessels and damage the retina, a layer of light-sensitive tissue at the back of your eye that allows you to see. When the barriers between the retina and the rest of the eye are damaged, fluid accumulates in the macula, the structure responsible for sharp, high-resolution vision.
That means managing your blood sugar can lower your risk of developing DME. Your hemoglobin A1c (HbA1c) measures how well your blood sugar is controlled over time—a HbA1c of 7% or greater is associated with a higher DME risk.
In addition, managing cholesterol levels may also help prevent DME. Evidence suggests that taking statins, a cholesterol-lowering medication, could lower the risk of DME by reducing inflammation and preserving the function of blood vessels in the eye. However, research is mixed.
Blood pressure is another important metric to follow—according to a 2023 study, the risk of DME is 24% higher in people with both diabetes and high blood pressure (hypertension).
Talk to your healthcare provider about your target ranges for blood sugar, blood pressure, and cholesterol. If any are out of range, medication or lifestyle changes can help.
There’s no way to completely prevent DME, but managing your blood sugar, blood pressure, and cholesterol levels can lower your risk. Certain lifestyle changes (in addition to medications) can help you accomplish those goals, including:
- Staying active: Exercise helps your body process insulin more efficiently, which supports better long-term blood sugar control. Plus, physical activity helps you lower your blood pressure, decrease cholesterol levels, and manage your weight.
- Maintaining a healthy diet: Choosing vegetables, fruits, lean proteins, and whole grains can support healthy blood sugar, blood pressure, and cholesterol.
- Quitting smoking: While some research has found that people who smoke might actually have a lower risk of DME, it’s important to remember that tobacco smoking is associated with more inflammation, worse blood sugar control, and higher blood pressure in people with diabetes.
DME often has no symptoms in its early stages. That’s why regular eye exams are crucial, even when your eyes feel completely fine.
Experts recommend that you have a comprehensive dilated eye exam at least once a year if you have diabetes. Your eye care professional will use drops to widen your pupils and see inside your eye to check for early signs of DME or other eye diseases.
If something looks off, an ophthalmologist (a doctor who specializes in eye conditions) may investigate with one of two common tests:
- Optical coherence tomography (OCT): A noninvasive scan that measures fluid buildup in your retina
- Fluorescein angiography: A test where dye is injected into a vein to reveal any leakage in the retinal vessels
Don’t wait for your next scheduled exam if you notice something feels off. Contact an ophthalmologist or optometrist right away if you experience:
- Blurry or distorted vision
- Colors that look washed out or faded
- Dark spots or wavy lines in your vision
If DME is caught early, treatment can prevent further vision damage. That’s one of the best reasons to keep up with your annual eye exams.
The most common treatment is anti-VEGF (anti-vascular endothelial growth factor) injections. These medications are injected directly into your eye to reduce inflammation and improve blood vessel health, which should stop fluid from leaking into the retina.
Laser treatment is another option. It reduces fluid leakage in the macula and helps stabilize your vision, though it can have some harmful side effects. Doctors might also use steroid injections or eye surgery to treat DME.
Your ophthalmologist will help you determine which treatment is best for you, which depends on the severity of your DME and how your body responds.
If you have diabetes and haven’t had a dilated eye exam recently, scheduling one is the best place to start. Ask your healthcare provider to refer you to an eye care professional with experience in diabetes-related eye conditions.
To reduce your risk of DME or slow progression, make sure you have healthy blood sugar, blood pressure, and cholesterol levels. If any of these metrics are abnormal, your doctor can help you make a plan to get them within a healthy range.
