Reta and retinopathy

[BigGuy73]

I have been diabetic for about 15 years now and started off by using metformin and Byetta back in 2010. I later switched to Victoza, then to Ozempic, then Mounjaro and now finally Reta. My A1C has usually been under 7 more like between 6.0 and 6.5 regardless of watching my diet. So far I haven’t had any complications.

I’ve been on Reta now for about 5 months and been slowly titrating my way up in dose to where I’m currently at which is 2.5 mg on Mondays, Wednesdays and Fridays a total of 7.5 mg per week. It has helped me lose some weight but nothing drastic.

I just had my annual eye exam today and was told that I have very mild diabetic retinopathy. The Dr stressed that it’s nothing to worry about and that if I tightened up on my sugar I probably won’t have any signs of it during my next exam a year from now. I did not tell him that I’m using Reta but told him that I’m using compounded Tirz. I didn’t tell him about Reta because it is not yet FDA approved and do not want my insurance company finding out about this. He also told me that I don’t have any signs that could contribute to NAION.

What’s your opinion guys? I’ve read that Reta can contribute to worsening retinopathy. Any T2 diabetics here in a similar situation?

Please let me hear your thoughts people. I want to stay on Reta but don’t want to possibly go blind either

 

[Calm Logic]

Are GLP-1 receptor agonists and diabetic retinopathy foes or friends?

Although the new GLP-1/GIP dual-receptor agonists and GLP-1/GIP/glucagon tri-receptor agonists show comprehensive benefit potential by effectively improving body metabolism, the short-term negative effect of sudden blood glucose drop still needs to be paid attention to.

 

[myopicmystic]

How has your BS control been over the last 6-12 months? Is this your first exam with this provider? The likelihood of developing diabetic retinopathy increases greatly with the duration of disease (aka how long you've been diabetic, whether or not you were diagnosed yet). Most mild changes change resolve with improved BS control or stable BS control depending on how variable you have been in the past.

When did your doctor tell you to come back? Don't feel the need to answer any of these questions here, but you can feel reassured if they said to come back anywhere from 5-12 months. If there were immediate concerns, they'd have you on a shorter exam frequency.

I personally haven't seen literature regarding reta exacerbating diabetic retinopathy yet, but I'll add it to my literature review list - thanks for the heads up.

 

[CNCCurrency]

I have been diabetic for about 15 years now and started off by using metformin and Byetta back in 2010. I later switched to Victoza, then to Ozempic, then Mounjaro and now finally Reta. My A1C has usually been under 7 more like between 6.0 and 6.5 regardless of watching my diet. So far I haven’t had any complications.

I’ve been on Reta now for about 5 months and been slowly titrating my way up in dose to where I’m currently at which is 2.5 mg on Mondays, Wednesdays and Fridays a total of 7.5 mg per week. It has helped me lose some weight but nothing drastic.

I just had my annual eye exam today and was told that I have very mild diabetic retinopathy. The Dr stressed that it’s nothing to worry about and that if I tightened up on my sugar I probably won’t have any signs of it during my next exam a year from now. I did not tell him that I’m using Reta but told him that I’m using compounded Tirz. I didn’t tell him about Reta because it is not yet FDA approved and do not want my insurance company finding out about this. He also told me that I don’t have any signs that could contribute to NAION.

What’s your opinion guys? I’ve read that Reta can contribute to worsening retinopathy. Any T2 diabetics here in a similar situation?

Please let me hear your thoughts people. I want to stay on Reta but don’t want to possibly go blind either

I wouldn't see how lowering your levels with a glp1 would worsen it.

 

[myopicmystic]

I wouldn't see how lowering your levels with a glp1 would worsen it.

100% a known phenomenon. Not solely GLP1 related

 

[CNCCurrency]

100% a known phenomenon. Not solely GLP1 related

Due to debates, not glp1's? Am I confused?

 

[myopicmystic]

Due to debates, not glp1's? Am I confused?

Diabetes and long term abnormal blood glucose will make blood vessels more fragile (everywhere but in this case, the eye). When you rapidly change the blood sugar averages through rapid weight loss like bariatric surgery or GLP1 use or even diet, it further destabilizes the already fragile vessels and can cause worsening in diabetic retinopathy. This usually isn’t permanent, mostly the first 6-12 months. So, for people with moderate to severe retinopathy, it can be something to keep an eye on.

 

[CNCCurrency]

Diabetes and long term abnormal blood glucose will make blood vessels more fragile (everywhere but in this case, the eye). When you rapidly change the blood sugar averages through rapid weight loss like bariatric surgery or GLP1 use or even diet, it further destabilizes the already fragile vessels and can cause worsening in diabetic retinopathy. This usually isn’t permanent, mostly the first 6-12 months. So, for people with moderate to severe retinopathy, it can be something to keep an eye on.

I still don't follow, so losing 1 to 1 /2 a week is considered rapid? From what I've seen all the dr's say that is perfectly fine.

 

[myopicmystic]

I still don't follow, so losing 1 to 1 /2 a week is considered rapid? From what I've seen all the dr's say that is perfectly fine.

No, I mean more than 2 a week long term and this is specifically in the context of diabetics.

 

[Lovedog100]

I got eye floaters the week that I started Ozempic. My doctor thought that it was nothing so I stopped using it, and saw three eye doctors that said that it was not connected with Ozempic. I started taking it again, now I have more floaters in my eyes. I don't believe that the eye doctors were read up enough on Ozempic. That said, the underlying problem is diabetes. You didn't say if you are type 1 or type 2. Type two is easier to control and you you are 2, then you are on the right track. Remember, Reta has not finished phase three trials, We are the test subjects.

 

[BigGuy73]

Hey guys, I’m a T2 diabetic and have been for the past 16 years. My last eye exam was last week and the dr told me that I have very early stage retinopathy and that as long as I get my sugar under control it should not get worse, he told me to come back in a year

 

[myopicmystic]

Hey guys, I’m a T2 diabetic and have been for the past 16 years. My last eye exam was last week and the dr told me that I have very early stage retinopathy and that as long as I get my sugar under control it should not get worse, he told me to come back in a year

So, having early/mild retinopathy after 15+ years is fairly common. Not knowing anything else about you, I wouldn’t think that reta is the sole factor. The literature doesn’t show direct causation from GLP1s, but we can’t be certain it doesn’t play a part.

The general advice to patients is good, stable glucose and blood pressure control, getting your labs checked on schedule, getting in exercise, maintaining a balanced diet, and weight loss as tolerated. Stuff you already know obviously or else you wouldn’t be on this site.