Retinopathy in Newly Diagnosed Type 2 Diabetics with a special stress on the importance of glycemic control (original) (raw)
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Correlation of blood sugar and HbA1C levels in different stage of diabetes retinopathy
International journal of health sciences
Objectives: This present study was to evaluate the different parameters and correlation of blood sugar and HbA1C levels for the development of retinopathy in type 2 diabetes mellitus patients. Methods: A complete assessment, general physical examination and routine haematological investigations were performed to all patients. A complete fundus examination was done with the help of direct and indirect Ophthalmoscope. Biochemical investigations (Blood Sugar- Fasting and Post Prandial, HbA1C level) were performed. Patients were called for follow up after 1 month, 3 months and 6 months. Results: A total of 100 patients of diabetes retinopathy were enrolled in this study. Most of the cases 67(67%) were males with age group of 51-60 years. out of 191 eyes, most of the cases 72(37.7%) had PDR. Rest cases had 58(30.36%) severe NPDR, 46(24.08%) moderate NPDR, 9(4.71%) others and 6(3.14%) mild NPDR. HbA1c levels of the most of the cases 94(49.21%) had 6.5-8.5. Most of the patients 170(89.53%...
Asian Journal of Medical Sciences, 2015
Objective: To assess the frequency of diabetic retinopathy (DR) and correlation with HbA1C in newly diagnosed type 2 diabetic patients. Patients and research methods: The study was conducted at a tertiary care medical centre in north india.All patients of >30 to <60 years of age, who were newly(within a month) diagnosed type 2 diabetes mellitus, according to world health organization(WHO)criteria and american diabetes association(ADA) recommendations,were included in the study. HbA1C was estimated from venous blood collected in ethylene diamine tetra acetic acid(EDTA) test tube, using boronate affinity chromatography (HPLC).Diabetic retinopathy was assessed by fundus examination using direct ophthalmoscope after dilatation of pupils.Early treatment diabetic retinopathy study(ETDRS) scale was used to assess the severity of diabetic retinopathy. Results: 28 % of the newly diagnosed cases were found to have diabetic retinopathy, of which 73.52% were of mild NPDR (non-prolifera...
Glycaemic control and development of retinopathy in Type 2 diabetes mellitus: a longitudinal study
Diabetic Medicine, 1998
Relationships between glycaemic control, hypertension, and development of microangiopathy have been well documented in Type 1 (insulin-dependent) but not in Type 2 (noninsulin-dependent) diabetes mellitus. Therefore, we have investigated these relationships in a cohort of 64 Type 2 patients free of retinopathy (by angiofluorography), who were regularly followed until development of retinopathy or for at least 7 years as outpatients. Glycaemic control was assessed by 1 to 4 HbA 1 determinations per year. Retinal status was monitored by annual angiofluorography. Nonproliferative retinopathy developed in 14 patients (cumulative incidence at 13 years: 29.8 %) after a mean diabetes duration of 14.3 ± 8.9 years (range 2-27). In multivariate analysis (Cox model), mean HbA 1 during follow-up (p Ͻ 0.001), and hypertension at first examination (p = 0.09) were associated with the development of retinopathy, but age, sex, BMI, diabetes duration, smoking, and fasting blood glucose were not. The relative risk for developing retinopathy (RR) was 7.2 (IC 95 %: 1.61-32.4) in patients with a mean HbA 1 during follow-up above the median value of the cohort (8.3 %) compared with patients with HbA 1 during follow-up below this value. RR was 2.5 (IC 0.8-8) in patients with HbA 1 at first examination above compared to below the median value (8.4 %). RR was 3.0 (IC 0.9-10) in patients treated for hypertension at baseline compared to those without treatment. A sixfold increase in retinopathy prevalence was observed between patients with mean HbA 1 in the highest or lowest quartile of mean HbA 1 distribution during follow-up. This longitudinal study indicates a strong association between long-term glycaemic control and the development of diabetic retinopathy in Type 2 diabetes.
2021
Diabetic Retinopathy (DR) is emerging fastly as one of the commonest causes of blindness. Globally in developed countries over 2.5 million people are blind due to diabetes. The risk of developing diabetic retinopathy or other micro-vascular complications of diabetes depends on both the duration and severity of hyperglycaemia. Present study is done to determine the prevalence of diabetic retinopathy (DR) in association with raise in HbA1c and also to correlate the severity of Diabetic retinopathy with the levels of HbA1c. A cross sectional study was conducted among 200 patients with diabetes mellitus attending the institute. All patients were subjected to relevant investigations, detailed slit lamp and dilated retinal examination. Diabetic Retinopathy was graded as per ETDRS categories. Among 200 patients, male: female ratio was 1.17. Majority of the patients were in the age group of 41 to 60 years. Present study shows that 52 had mild NPDR, 15 had moderate to severe NPDR and 13 had ...
Correlation between HbA1c and Diabetic Retinopathy in Type 2 Diabetes Mellitus
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Type 2 diabetes mellitus is now a common and a global health problem in both developed and developing country due to dietary change, reduced physical activities, increase urbanisation, increasing age and unhealthy life style. Risk of diabetic retinopathy increases with increase in duration and severity of hyperglycaemia. HbA1c is the important predictor for treatment and risk of developing microvascular and macrovascular complications. So, correlation between HbA1c and diabetic retinopathy in type 2 diabetes mellitus is depicted in our study. We wanted to study the relationship between HbA1c and diabetic retinopathy in type 2 diabetes mellitus and correlate the severity of diabetic retinopathy with increase in levels of HbA1c. METHODS It is an observational study done in tertiary care hospital from September 2018 to August 2019. 200 patients who were referred from endocrinology department for funduscopic examination having complaints of vision loss were enrolled in the study. Age, sex, duration of diabetes, FBS, PPBS, HbA1c value, and funduscopy findings were recorded. Patients were followed up for 3 months. RESULTS 200 patients were included in the study. 115 (57.5%) were male, 85 (42.5%) were female. Male:Female ratio was 1.35:1.80 (40%), had HbA1c value >14.5; 50 (25%) patients had 12.6-14.5; 38 (19%) patients had 10.6-12.5; 22 (11%) patients had 8.6-10.5; and 10 (5%) patients had 7-8.5. CONCLUSIONS Severity of diabetic retinopathy increases in patients with higher value of HbA1c. HbA1c is the predictor of severity of diabetic retinopathy.
Correlation between HbA1c Levels and Severity of Diabetic Retinopathy
DIPONEGORO MEDICAL JOURNAL (Jurnal Kedokteran Diponegoro)
Background: In recent years, Diabetes Mellitus (DM) has emerged as the world's leading cause of death with the potential to develop micro vascular complications in the form of retinopathy. HbA1c is an indicator to identify hyperglycemia and plays an important role in monitoring the development of complications due to DM. This study is undertaken determine the relationship between HbA1C levels and the severity of diabetic retinopathy in DM patients. Aim: To identify the relationship between HbA1c levels and different stages of diabetic retinopathy. Method: An analytic observational, cross sectional design, using patients’ medical record. Patient data consisted of gender, age, DM duration, HbA1c levels, and stages of diabetic retinopathy. Non parametric correlation Spearman’s rho was chosen for statistical analysis. Result: A total of 72 DM patients consisted of 29 men and 43 women with a mean DM duration 10.4 years. A total of 37 patients were diagnosed with diabetic retinopathy ...
Acta Ophthalmologica Scandinavica, 2009
To study the progression of retinopathy in patients with mild diabetes mellitus, we examined, in a cohort study, 347 patients treated with diet alone at baseline. The patients participated in an ophthalmological screening and control programme, and diet-treated patients who were examined between January 1990 and July 1992 were included in the study and followed until October 1995. Mean follow-up time was 3.4 f 1.1 years. The alternative classification of the Wisconsin study was used to classify retinopathy, and the mean HbA,, values for the study period, to estimate the level of glycaemic control. At baseline, 314 of the patients (90.5%) had no retinopathy, and 33 (9.5%) had mild non-proliferative diabetic retinopathy. In 296 patients there was no retinopathy progression, in 27 patients there was progression by 1 level in the retinopathy scale, and in 24 patients by 2 levels or more. In 2 patients there was progression to proliferative diabetic retinopathy. The mean HbA,, (%) was 6.5 k 1.3. Higher HbA,, correlated to increased progression (r = 0.16; p = 0.005), and in a multivariate analysis, HbA,, remained associated with a progression of retinopathy by 2 levels or more, with a relative risk of 1.4 per percent increase in HbA,, (95% CI 1.1-2.0; p = 0.02). Furthermore, the presence of any retinopathy at baseline was associated with progression with a relative risk of 1.7 (95% confidence interval 1.1-2.8; p = 0.02). These data indicate that even slightly elevated levels of HbA,, might be associated with a risk of retinopathy progression.
KYAMC Journal
Background: Retinopathy is the leading cause of blindness in persons with diabetes. Strict monitoring and maintenance of normal blood glucose specially HbA1c and prevention of different risk factors can prevent and delay the diabetic retinopathy. The purpose of the study was to explore the factors influencing or related to the development of the diabetic retinopathy with spcial concern to the HbA1c levels. Materials and Methods: We studied 400 type 2 diabetic patients in this cross-sectional study which was conducted in the outpatient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of retinopathy through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, BMI) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's t-test, Chi-square test and logistic regression analysis to determine and quantify the association of diabetic retinopathy with various risk factors specially HbA1c. Results: 400 type 2 diabetic patients (male 166 and female 234) were studied. The prevalence of retinopathy was 12.3%; male 12.7%, female 12.0%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of retinopathy (4.2 vs 12.3 vs 18.1%; 2 = 12.529, p < .01). Logistic regression models of univariate analysis showed that the risk of retinopathy at HbA1c categories >7.0% was (
ABSTRACT Objective: Early worsening of diabetic retinopathy (EWDR) due to the rapid decrease of blood glucose levels is a concern in diabetes treatment. The aim of the present study was to evaluate whether this is an important issue in subjects with type 2 diabetes with mild or moderate non-proliferative DR (NPDR), which represent the vast majority of subjects with DR attended in the Primary Care. Research Design and Methods: retrospective nested case-control study of subjects with type 2 diabetes and previous mild or moderate NPDR. Using SIDIAP (“Sistema d'informació pel Desenvolupament de la Recerca a Atenció Primària”) database, we selected 1,150 individuals with EWDR and 1,150 matched controls (DR without EWDR). The main variable analyzed was the magnitude of the reduction of HbA1c in previous 12 months. The reduction of HbA1c was categorized in rapid (>1.5% reduction in < 12 months) and very rapid (>2% in <6 months). Results: We did not find any significan...
Journal of the Royal Society of Medicine
The possible relationship between antecedent diabetic control, as determined by serial glycosylated haemoglobin (HbA1) measurements, and diabetic retinopathy was examined in 40 insulin-dependent and 41 non-insulin-dependent diabetics selected consecutively from our clinic population. Multiple logistic regression analysis demonstrated a significant association between mean HbAj and prevalence of retinopathy in both groups of patients. This association was independent of duration of diabetes which was also significantly associated with retinopathy prevalence. Hypertension and smoking were not obvious risk factors in this group of patients; an apparent association of hypertension and diabetes was entirely accounted for by a positive relationship between the presence of hypertension and duration of diabetes.