Blindness caused by type 2 diabetes curbed by diet change

Macular oedema is one of the most feared side effects of diabetes, but a growing number of patients are putting it into remission through a new lifestyle.

Adelaide local Sujatha Rice, with daughters Hannah, left, and Lydia, says her diabetic symptoms returned worse in each successive pregnancy. Picture: Keryn Stevens

An ophthalmologist has successfully reversed diabetes-related blindness through dietary change across dozens of patients, marking an extraordinary success in treatment of diabetic conditions through lifestyle interventions.

James Muecke is acclaimed for his focus on the treatment of macular oedema through dieting, having received the Australian of the Year award in 2020 for his work in the field.

Macular oedema is caused by the swelling and bursting of blood vessels in the eyes, obscuring ­vision.

It’s most commonly associated with type 2 diabetes and is the leading cause of blindness among working-age adults in Australia.

Diabetes significantly impacts the body’s ability to metabolise carbohydrates, so by prescribing a ketogenic (high fat, low carb) diet, Dr Muecke helped patients healthily promote metabolism.

“Show me any medication that can have such a profound and rapid impact on the life-changing consequences of type 2 diabetes,” he said. “This benefit is happening in all the tissues, throughout the body. As an eye specialist, I have the extraordinary privilege of being able to see the damage being wrought by metabolic dysfunction, and the even more extraordinary privilege of seeing it reverse with lifestyle changes.”

Keto diets focus on reducing carbohydrates and providing the body’s energy through healthy fats while limiting trans fats and processed food.

2020 Australian of the Year James Muecke and former PM Scott Morrison. Picture: AAP

Adelaide local Sujatha Rice developed gestational diabetes at 21 during her first pregnancy. A mother of six, her diabetic symptoms returned worse in each successive pregnancy.

“We found out I was pregnant again at 39, and things had changed a bit over that time. I hadn’t been taking care of my diabetes, meanwhile, which had turned into type 2,” Ms Rice said.

“Then I noticed quite a bit of disturbance in my vision.”

She was diagnosed with macular oedema and found her diabetes resistant to medication. “It progressed throughout the pregnancy, and my vision kept getting worse,” she said.

A patient of Dr Muecke, Ms Rice began seeing a nutritionist and her diabetes went into remission in two weeks through stringent lifestyle changes. She said it was a demanding treatment that required a high degree of patient involvement.

Exercise physiologist Ray Kelly.

“It is so easy to sort of slip back to some baseline … then before you know it, the blood sugars are creeping up again,” she said.

Bevan Bruse, 72, agreed it was a difficult treatment. A diabetic of more than a decade, he was the first patient recorded to have put his diabetes into remission through a keto diet.

“It’s been a ­really great success for me,” he said. Mr Bruse experienced one of the most dramatic remissions of the 25 patients engaged in keto therapy under Dr Muecke. Initially receiving hormone injections in his eyes every eight weeks, he was able to come off insulin less than two months after changing his diet. Over the following years he tapered off the eye injections entirely.

While the treatment of diabetes as a reversible condition has not seen universal adoption, exercise physiologist Ray Kelly has been on the same course as Dr Muecke for years in treating diabetes in Indigenous communities.

“If you look at the first nationwide report on Aboriginal health in 1979, it showed Aboriginal people who live more traditionally had virtually zero diabetes,” he said.

“I’ve taken the principles of this older knowledge and modernised it for (those) going to … the supermarket chains.”