How to prevent Diabetic Retinopathy with good glucose control?

It is very important that you get good blood glucose control. Now that does mean sometimes that we put patients at risk when we tighten up the blood glucose control very rapidly. That is in situations where the benefits of tight blood glucose control outweigh the dis-benefits of it. Primarily for me, this is often in women who have become pregnant and they have poor blood glucose control and you have to get tight blood glucose control rapidly because you're trying to prevent congenital abnormalities for the developing baby. So you have to take that risk. It is not common but what you therefore do is you have tight surveillance so you get patients to have an early retinal review as in by an ophthalmologist. What you do is I'm sure many of your patients already have this yearly digital retinal photographs and it's very important that they attend those because that picks up early disease which we can act upon and to prevent further disease. But yeah, we would then do frequent, during pregnancy, we would do frequent eye examinations as using digital retinal photography and treating those women early with laser therapy if needed, and those are not associated with any effects on the fetus, so you don't need to worry about that. you