The definition of diabetes is pretty simple. It means the body can’t make insulin or use insulin well. But diabetes—extreme variations in the levels of sugar in the blood—is a complex disease and impacts nearly every part of the body. 

The eyes are no exception. Diabetic retinopathy is a condition that affects the retina—the part of the eye that senses light and sends signals to the brain about what we see. Diabetic retinopathy is the leading cause of blindness in working-age adults in the United States, according to the National Eye Institute.

The good news is that more than 95 percent of diabetes-related vision loss can be prevented, says Rahul N. Khurana, M.D., a vitreoretinal surgeon and clinical spokesperson for the American Academy of Ophthalmology. If caught early, vision problems that do exist can often be stopped or reversed with treatment.

One of the most important steps is an annual appointment with your eye doctor that includes an examination of the retina. Your doctor may use a retinal camera or dilate your pupils to examine the retina. 

“A lot of times, people aren’t aware of the changes taking place in their eyes from diabetes,” says Dr. Khurana. Annual eye exams are the best way to notice changes early.

But when it comes to diabetes management, protecting your vision doesn’t end with your eye checks. In fact, some of the numbers that your primary-care doctor and diabetes specialists track are important when it comes to your eye health.

Here’s what you need to know and do for diabetes management.

A1C: Get Tested a Few Times a Year for Diabetes Management

The A1C test is used to measure a person’s average blood sugar over the previous 2 to 3 months. 

“Clinical trials have shown that improving A1C can improve diabetic retinopathy and prevent vision loss,” says Dr. Khurana. In fact, for every 1 percent that A1C falls, there is about a 40 percent drop in the risk of problems related to diabetic retinopathy.

Rein it in: A stable A1C number means that a diabetes care plan is working well. Call your health-care team if you’re having trouble with any part of your plan so they can help you adjust it until it works for you. 

Also get your A1C checked as often as your doctor says you should—usually every 3 to 6 months.

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Blood Pressure: Keep It Low for Diabetes Management

Two-thirds of people with diabetes also have high blood pressure, which has been linked to diabetic retinopathy. High blood pressure—when either number is above 120/80—can lead to blockages in the blood vessels in the eye, which can cause them to leak fluid and cause nerve-cell damage. 

Rein it in: High blood pressure does not have obvious symptoms, so get it checked at every visit with every type of doctor. Again, keeping it stable is key. Also ask your diabetes doctor how much to cut back on sodium and alcohol, both of which can raise blood pressure. 

Cholesterol: Build a Healthier Profile for Diabetes Management

People who have diabetes are more likely to have lower levels of “good” cholesterol and higher levels of triglycerides and “bad” cholesterol—the exact opposite of what you want.  

When cholesterol builds up in the arteries, it makes them narrower or blocks them completely. If this happens in the retina (a structure at the back of the eye), it can cause swelling and the growth of abnormal blood vessels, all of which can harm vision.

Rein it in: Following a diet that is low in fat, processed carbs, and cholesterol can help improve your blood fats profile. The American Diabetes Association recommends allocating your plate like this: 50 percent non-starchy vegetables, 25 percent protein, and 25 percent healthy grains and starchy foods.

Extra Vision Boost: Quit Smoking for Good

Smoking raises the risk of diabetes, as well as the risk of diabetic retinopathy. Cigarette smoke can also irritate the eyes of smokers (and secondhand smokers), contributing to dry-eye syndrome and other problems. As if that weren’t bad enough, tobacco use also boosts bad cholesterol and blood pressure.