Class R diabetes is diabetes that is associated with retinopathy. Diabetic retinopathy is caused by damage to the blood vessels in the retina. It is the most common eye disease in diabetes. A person with Class R diabetes will not notice changes in their vision at first. Overtime it gets worse and causes vision loss. Worst of all, it usually affects both eyes.
There are four stages of diabetic retinopathy, they are:
Mild Nonproliferative Retinopathy – This is the earliest stage, where microaneurysms occur. Microaneurysms are small areas of balloon-like swelling in the retina’s tiny blood vessels.
Moderate Nonproliferative Retinopathy – The disease progresses and some blood vessels, which nourish the retina, are blocked.
Severe Nonproliferative Retinopathy – In this stage many more blood vessels are blocked. This deprives several areas of the retina of a blood supply. Signals are sent to the body to grow new blood vessels.
Proliferative Retinopathy – This is the advanced stage of the condition, where signals are sent to the body to grow more blood vessels for nourishment. However, the new blood vessels are abnormal and fragile. If their thin walls leak blood, they cause severe vision loss and maybe even blindness. Proliferative Retinopathy is Class R diabetes.
Class R Diabetes and Pregnancy
The progression of diabetic retinopathy may rapidly increase rapidly in pregnancy. This is very serious, yet good diabetic control can prevent this, or make it less severe at least. If retinopathy is not present just before pregnancy, rescreening is needed at 28 weeks because 10% of women with diabetes retinopathy during pregnancy.
Even with good blood sugar control, retinopathy may manifest during pregnancy. Proliferative retinopathy, or Class R diabetes, may develop towards the end as well. If this occurs, laser surgery will be needed urgently. If pre-proliferative disease is already present before pregnancy, a lot of laser surgery may be needed. Luckily, laser surgery makes little difference in pregnancy. Even the drops used to dilate the pupils are relatively safe, as long as the surgeon knows about the pregnancy.
According to DiabeticRetinopathy.org, if there was no retinopathy prior to pregnancy, retinal checks should occur 3 times monthly during your pregnancy. Most women attended a joint clinic that is attended by an obstetrician that is an expert in diabetic pregnancies. If the diabetes was uncontrolled and retinopathy was present prior to pregnancy, the checks need to be done by an ophthalmologist who is an expert in retinopathy. This way it does not develop into Class R diabetes.
