- Always take your diabetic treatment as not doing so is harmful.

- Control your diet.

- Avoid becoming overweight.

- Avoid smoking and alcohol.

- Have regular blood pressure checks.

Two of the major insulin manufacturers have admitted that 'human' insulin therapy may cause serious adverse reactions. These are very much in line with the evidence from a large number of patients.

18 years after genetically engineered 'human' insulin was introduced, there is still no evidence of any clinical benefit for patients and patients in countries around the world have complained of adverse reactions to it. These largely regress with a change to natural animal insulin but this is being systematically withdrawn from the market for commercial reasons. Patients reporting adverse reactions have been largely ignored by regulatory bodies, doctors and healthcare professionals.

On April 24th 2000, insulin manufacturer, Aventis Pharmaceuticals, issued the following statement in a press release:

The statement put in the public domain by the insulin manufacturer themselves, has very serious implications for people with diabetes. The risk/benefit ratio for insulin treatment may have shifted from 'human' insulin to animal insulin and present prescribing habits may be putting some people at risk of unnecessary and avoidable complications to which they are already susceptible. Increased risk of retinopathy is a particular worry because diabetes is the largest cause of blindness in the working population. Any increased risk of blindness or visual impairment is unacceptable to patients when there are natural insulins available that have not been said to cause such risks.

You should tell the DVLA and your motor insurers, if you have retinopathy that requires treatment, that is affecting your vision or visual fields. It is a condition that should be declared under the item 'has there been any material change that could affect your driving.' If you were involved in an accident and you had not declared that you have retinopathy, then you may not be insured and the DVLA could take action because you have not informed them.

An article in Diabetes Interview [US March 1999] really made me think. We all read about miracle cures for various illnesses and I expect you, like me, treat them with some of scepticism. But this article really made me wonder if we should not treat some of these things with a more serious approach.

Apparently French people with diabetes and retinopathy are often treated with a patented pill called Pycnogenol - unheard of in the US and I don't know about over here. Pycnogenol apparently is made up of a particular group of bioflanonoids that have been shown to improve the elasticity of the very small blood vessels [capillaries]. It has also been shown to have antioxidant powers that get rid of the free radicals - these are harmful molecules that lead to vascular and other problems. Diabetes Interview talks to a man who was diagnosed with retinopathy requiring laser treatment in 1982. He searched for a possible solution himself and found Pycnogenol in France - his retinopathy regressed and he has had no laser treatment. At this point I say to myself, well this could happen naturally but……..

- A study published in Ophthalmic Research in 1996 proved Pycnogenol's beneficial effects on the retinas of pigs and cows.

- In the Journal of Cardiovascular Pharmacology, October 1998, it was shown to counteract the blood vessel restricting effects of adrenalin, to decrease the clogging of blood vessels by decreasing platelet clustering and adhesion.

- In the journal Free Radical Biology and Medicine, May 1998, it was shown to significantly decease nitrogen monoxide generation [this is important in many disease including diabetes].

- In Biotechnology Therapeutics, 1994-95, it was shown to protect the cells lining the lymphatic vessels and the heart from injury due to oxidation.

In a recent study published in Phytotherapy Research [15;1-5:2001] 30 people with diabetes were treated with 50-mg doses of Pycnogenol 3 times a day for 2 months and 10 people in a control group were treated with a placebo [dummy pill]. The researchers found that in those who took Pycnogenol there was a slowing down of the progression of retinopathy and in some cases the progression actually halted but in the control group using the placebo, retinopathy only got worse.

This is only a small study and therefore it must be treated with caution. However, despite efforts to achieve near normal blood glucose levels, in industrialised countries diabetic retinopathy is still the leading cause of blindness in the working population emphasising a clear need to investigate all possible avenues to prevent people from becoming blind or visually impaired. Therefore IDDT welcomes the findings of this study and believes that it should not be dismissed because Pycnogenol is a herb. There needs to be further independent studies using Pycnogenol involving greater numbers of participants over a greater duration of time.

The use of Pycnogenol must not be a seen as a substitute for 'good' control and because of its powerful antioxidant effects should only be used in consultation with your medical adviser, as indeed should all supplements and complementary medicines. It is also essential that the use of Pycnogenol does not replace essential regular eye examinations.

Note - More information is available on the manufacturer's website www.Pycnogenol.com or if you would like copies of the IDDT Newsletters containing the original articles about Pycnogenol, contact IDDT, PO Box 294, Northampton NN1 4XS, tel. 01604 822837 or e-mail enquiries@iddtinternational.org

The law requires that you must inform the DVLA in Swansea and your motor insurers if there are any changes in health or sight that could affect your ability to drive safely. Failure to do this could result in prosecution and your motor insurance being invalid.

To drive a car, you are required to be able to read a number plate at 25 yards or 20.5 metres with both eyes together, in good daylight and with glasses if worn. You must also have an adequate field of vision. The DVLA may require a report from your ophthalmologist about your eye condition. You must NOT drive until your specialist has confirmed that you meet the required standards. To drive vocational vehicles, the standards are more stringent.

Dispensing opticians - are qualified to fit and measure for glasses and to examine conditions that affect the outside of the eye. They are not allowed to test the eyes for glasses or to examine the inside of the eye - for example with an ophthalmoscope. They are allowed to fit and supply contact lenses to a supplied prescription.