MONDAY, April 14 (HealthDay News) -- Diabetic retinopathy, a leading cause of vision loss in the United States, is also a warning sign of heart failure, a new study says.
The study followed more than 1,000 middle-aged people with type 2 diabetes for nine years and found that those with retinopathy at the start had more than a 2.5-fold higher risk of developing heart failure than those without retinopathy.
The finding was published in the April 22 issue of the Journal of the American College of Cardiology.
"They have made the point that patients with diabetic retinopathy need to be more vigilant in looking for the development of heart failure," said Dr. Hector O. Ventura, director of the cardiology residency program at the Ochsner Health System in New Orleans, and co-author of an accompanying editorial in the journal.
The physical connection between retinopathy -- which is caused by leakage and/or overgrowth of tiny blood vessels in the eye -- and heart failure -- which is the progressive loss of the ability to pump blood -- is not clear, Ventura said. But the new study strengthens evidence for such a link, he said.
A relationship between diabetic retinopathy and an increased risk of heart failure was first described two decades ago in the long-running Framingham Heart Study, which follows residents of a Massachusetts city, the journal report noted.
A number of later studies found a similar relationship. The research team behind the new study, an international group with members in Australia, Singapore and the United States, described the retinopathy-heart failure association in detail two years ago in a study of people with diabetes in four communities.
The new study singled out retinopathy as a heart risk factor by selecting participants who were free of kidney disease and coronary heart disease, two major risk factors for heart failure.
Just 125 of the participants had diabetic retinopathy at the start of the study. After nine years, heart failure was diagnosed in 27 of them, an incidence of 21.6 percent. The incidence in those without the eye condition was 8.5 percent.
Guidelines for treatment of retinopathy do not mention heart failure, but perhaps they should, Ventura said. "Maybe the guidelines one day will say that if you have retinopathy, you should see a cardiologist," he said.
It's possible that the same kind of trouble with the eyes' microvasculature -- the tiniest blood vessels -- can also have an effect on the heart over the decades, the study authors said.
Retinopathy could be an indicator of inflammation and other damage to the endothelium, the delicate inner lining of blood vessels, Ventura said.
Dr. Nancy Sweitzer, director of the heart failure program at the University of Wisconsin, said, "The interesting thing about this study was that the association was as strong for mild degrees of eye disease as for strong degrees. It has to be taken very seriously."
While the study doesn't break new ground, she said, "no one has ever looked in such a detailed way at the association between disease in microvessels and heart failure."
Cardiologists have become more concerned about the coronary effects of diabetes in recent years, and people with diabetes should act on that concern, Sweitzer said. "They should talk to their doctor about diabetes in general, not just about retinopathy," she added.
More information
Learn more about diabetic retinopathy from the U.S. National Eye Institute.
SUNDAY, April 13 (HealthDay News) -- Rising food prices may have people with diabetes and their caregivers wondering if they'll be able to afford a healthy diabetes meal plan. But it's a misconception that these plans have to be costly and consist of high-priced, specialty foods, the American Diabetes Association says.
"Eating well and spending less are not mutually exclusive," Ann Albright, president of health care and education at the ADA, said in a prepared statement. "In fact, healthier foods can actually save you money by reducing portion sizes and buying fewer high-calorie, high-priced foods."
The ADA offers the following advice:
- Special "dietetic or diabetic" foods are costly and not necessary.
- Boneless cuts of meat are often a better buy, since you're not paying for the weight of the bone.
- There's no nutritional difference between white eggs and brown eggs, which are more expensive.
- Not only do vegetables frozen in butter sauce cost twice as much as plain frozen vegetables, they have more calories.
- Instead of buying small containers of yogurt, buy a quart and separate it into one-cup servings yourself.
- You can save a lot of money if you don't buy individually packaged snacks.
- When buying fruit, consider the cost per edible serving. If you're paying by the pound, you'll be paying for the weight of inedible seeds and rinds.
- If fresh fruit is too expensive, buy frozen or canned fruit packed in water. If you buy fruit canned in syrup, rinse it before eating.
- Use nonfat dry milk for drinking, cooking and baking. It's inexpensive and has a long shelf life.
- You can make your own cooking spray by putting vegetable oil in a spray bottle.
- Use regular or quick-cooking oats rather than instant oats, which are much more expensive.
- When soaked and cooked, dry beans triple in volume. A one-pound bag will make six one-cup servings.
- If you buy fresh greens by weight, give them a good shake before you put them in your grocery cart. An amazing amount of excess water (and weight) can be hidden between the leaves.
More information
The American Academy of Family Physicians has more about diabetes and nutrition 
.