scholarly journals First nation-wide study of diabetic retinopathy in Poland in the years 2013–2017

2020 ◽  
Vol 57 (10) ◽  
pp. 1255-1264
Author(s):  
Milena Kozioł ◽  
Michał S. Nowak ◽  
Monika Udziela ◽  
Paweł Piątkiewicz ◽  
Iwona Grabska-Liberek ◽  
...  

Abstract Aims To assess the prevalence and time trends of diabetic retinopathy (DR) in the overall population of Poland from 2013 to 2017 and diagnose the risk factors of occurring DR among patients with diabetes mellitus (DM). Methods Data from all levels of healthcare services at public and private institutions recorded in the National Health Fund (NHF) database were evaluated. International Classification of Diseases codes (ICD-9 and ICD-10) and unique NHF codes were used to identify DM type 1 and type 2 patients, DR and treatment procedures including laser photocoagulation, pars plana vitrectomy (PPV), anti-VEGF and steroid intravitreal injections. Results The overall registered prevalence of DR in the entire population of Poland was 0.81%. The mean prevalence of DR was 20.01% in the population with type 1 DM and 9.70% in the population with type 2 DM. In the study period, women represented 56.36% of all individuals registered with DR and 55.09% of all DM patients. In Poland, only 6.34% of all DM patients with DR received specific treatment with laser photocoagulation of the retina (82.32%), PPV (11.56%), anti-VEGF or steroid injections (5.15% and 0.97%, respectively). Cox regression hazard analysis showed that the risk of DR was associated with DM treatment only by GPs, female sex, coexisting systemic diseases and urban residence in both type 1 and type 2 DM. Conclusions A 5-year retrospective analysis reveals the mean prevalence of DR in the population with type 1 and type 2 DM in Poland was rather low.

Author(s):  
Jui-Yang Wang ◽  
Hsin-Chung Lin ◽  
Hsin-An Lin ◽  
Chi-Hsiang Chung ◽  
Lih-Chyang Chen ◽  
...  

Patients with diabetes mellitus (DM) are at greater risk of developing active tuberculosis and other intracellular bacterial infections, although the risk of acquiring infections from nontuberculous Mycobacterium (NTM) remains undefined. This study evaluated associations between DM and incidence of NTM infection-caused pulmonary and cutaneous diseases. Data for DM patients were extracted from the National Health Insurance Research Database of Taiwan. The DM cohort included 136,736 patients, and cases were matched randomly by age, gender, and index year with non-DM patients. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios of incident NTM-caused diseases in the DM cohort compared with non-DM control subjects. The frequency of incident NTM-caused diseases was significantly greater in DM patients (0.12%) than in non-DM patients (0.08%) (P < 0.05), including patients with type 1 DM (0.12%) and type 2 DM (0.12%) (all P < 0.05). Adjusted multivariate Cox regression analysis revealed that the incidence of NTM-caused diseases in DM patients was 1.43-fold greater than that in non-DM patients overall (P < 0.05), particularly in pulmonary (1.13-fold), other specific (excluding pulmonary, cutaneous, and disseminated diseases; 3.88-fold), and unspecific (atypical NTM infection; 1.54-fold) diseases (all P < 0.05). In conclusion, both type 1 DM and type 2 DM patients have high risk of NTM-caused diseases, suggesting that physicians need to pay more attention to this issue concerning the high risk of NTM-caused infection in DM patients.


Author(s):  
Milena Kozioł ◽  
Michał S. Nowak ◽  
Beata Koń ◽  
Monika Udziela ◽  
Jacek P. Szaflik

IntroductionThe aim of our study was to analyze the regional differences in diabetic retinopathy (DR) prevalence and its co-existing social and demographic factors in the overall population of Poland in the year 2017.Material and methodsData from all levels of healthcare services at public and private institutions recorded in the National Health Fund database were evaluated. International Classification of Diseases codes were used to identify patients with type 1 and type 2 diabetes mellitus (DM) and with DR. Moran's I statistics and Spatial Autoregressive (SAR) model allowed to understand the distribution of DR prevalence, and its possible association with environmental and demographic exposures..ResultsIn total, 310,815 individuals with diabetic retinopathy (DR) were diagnosed in the year 2017 in Poland. Of them, 174,384 (56.11%) were women; 221,144 (71.15%) lived in urban areas; 40,231 (12.94%) and 270,584 (87.06%) had type 1 and type 2 DM, respectively. The analysis of the SAR model showed a higher level of average income and a higher number of ophthalmologic consultations per 10 000 adults in the particular county were the significant factors for the occurrence of DR in the counties.ConclusionsThe analyses of social, demographic, and systemic factors co-existing with DR revealed that the level of income and the access to the ophthalmologic and diabetic service are crucial in DR prevalence in Poland.


2021 ◽  
Vol 15 (12) ◽  
pp. 3387-3389
Author(s):  
Iftikhar , Ahmad ◽  
Fatima Akbar Shah ◽  
Muhammad Abid Javed ◽  
Muhammad Ahsen ◽  
Hafiz Huzaifa Akhlaq ◽  
...  

Study Objectives: To determine the relationship of central corneal thickness with the status of diabetic retinopathy and level of HbA1c in diabetic patients. Study Design and Settings: Department of Ophthalmology, Allied Hospital/DHQ Hospital, Faisalabad Pakistan from Jan 2021 to June 2021. Patients and Methods: Out of the patients visiting OPD, 100 patients with clinically diagnosed type 2 DM which satisfied the range of selected standards and offered written informed agreement were involved in the research with the use of simple random sampling. Snellen’s visual acuity chart for distance vision and Jaeger’s chart for near vision were used to determine the best-corrected visual acuity. Wet Refraction and axial length was measured using A-scan. Goldmann applanation tonometry was used to measure the intraocular pressure. Results of the Study: In this research sixty two percent of the patients were men and thirty eight percent patients were women. Total 84 patients had type 2 DM of duration 5-10 years, and the remaining 16 patients had diabetes for over 10 years. Total 35 patients had HbA1c between 4-5.6%, 31 patients had HbA1c between 5.7- 6.5% and 34 patients had HbA1c ≥ 6.5%. From 100 patients with Diabetes Mellitus Type 2, 21 patients had no diabetic retinopathy, 28 patients had very minor and minor NPDR, 25 patients had average NPDR, 19 patients had critical and very acute NPDR and 7 patients had PDR. The mean HbA1c in patients with no diabetic retinopathy was 5.05%. The mean HbA1c in patients having minor and very little NPDR remained 5.64%. The mean HbA1c in patients with moderate NPDR was 6.36%. The mean HbA1c in patients with critical and very acute NPDR was 8.26%. The mean HbA1c in patients with severe PDR was 9.86%. This was a statistically significant survey (P-value = 0.01). Conclusion: This study showed a strong correlation between the central corneal thickness to the severity of diabetic retinopathy and HbA1c levels emphasizes the importance of evaluation of corneal endothelial morphology in the early screening and diagnosis of microvascular complications of DM Keywords: Central Corneal Thickness, Diabetic Retinopathy, HbA1c


2021 ◽  
Author(s):  
Kholoud Albokhary ◽  
Feda Aljaser ◽  
Manal Abudawood ◽  
Hajera Tabassum ◽  
Afnan Bakhsh ◽  
...  

Background: Diabetic retinopathy (DR) is a sight-threatening complication of diabetes mellitus (DM). Oxidative stress generated on account of hyperglycemic state may lead to retinal abnormalities including DR. Objectives : To evaluate the status of antioxidant enzymes -superoxide dismutase (SOD) and catalase (CAT); with different stages of DR severity in subjects with type 1 and type 2 DM. Methods: The cross-sectional study enrolled 148 subjects with type 1 DM (n=17); type 2 DM (n=96) and non-diabetes controls (n=35). Subjects with DM were divided into two subgroups based on DR severity (mild-to-severe non-proliferative DR and proliferative DR [PDR]) and Serum glycated hemoglobin (HbA1c), lipid profile, SOD and CAT were estimated. Results: Both SOD and CAT levels were lower in diabetes subjects than non-diabetic controls. A significant positive correlation was found between HbA1C level and severity of DR (P<0.0001). Levels of SOD and CAT varied significantly with DR severity in both diabetic groups at p<0.05. Furthermore, levels of SOD and CAT was found to decrease significantly (P<0.001) in DR (+) compared to DR (-) patients. Also, increased levels of HbA1c was significantly associated (P<0.001) with decreased SOD in both subgroups (NPDR and PDR). DR severity was significantly associated with SOD and CAT in the NPDR and PDR subgroups (P<0.05). Conclusion: Oxidative stress and decreased antioxidant defenses are associated with DR progression to its PDR stage.


2020 ◽  
pp. bjophthalmol-2020-316030
Author(s):  
Chloé Chamard ◽  
Vincent Daien ◽  
Ali Erginay ◽  
Jean-Francois Gautier ◽  
Max Villain ◽  
...  

BackgroundTo estimate the 10-year incidence of referable diabetic retinopathy (DR) in a French population with type 1 and 2 diabetes mellitus (DM). A secondary objective was the assessment of safe screening intervals in patients with diabetes without retinopathy.MethodsObservational, prospective and multicentric study between June 2004 and September 2017 based on a regional screening programme for DR in the Paris region. The incidence of referable DR in patients without retinopathy at baseline was calculated by the Turnbull survival estimator. A safe screening interval was defined as a 95% probability of remaining without referable DR.ResultsAmong the 25 745 participants with type 1 (n=6086) or type 2 (n=19 659) DM, the 10-year cumulative incidence of referable DR was 19.10% (95% CI 17.21% to 21.14%) and 17.03% (15.78% to 18.35%), median (IQR) follow-up=3.33 (4.24) years. The safe screening interval for patients without DR at the first examination for type 1 and 2 DM was 2.2 (95% CI 2.0 to 2.4) and 3.0 (2.9 to 3.1) years, respectively. In a subgroup of low-risk patients with type 2 DM, the safe screening interval was 4.2 (3.8 to 4.6) years.ConclusionsThese data suggest that in Paris area, a 2-year, 3-year and 4-year screening interval was considered safe for type 1 DM, type 2 DM and for low-risk patients with type 2 DM, respectively, without DR at the first examination. While these data might be used to support the consideration of extending screening intervals, a randomised clinical trial would be suitable to confirm the safety for patients with DM.


2019 ◽  
Vol 3 (3) ◽  

Background: Diabetes mellitus (DM) is a metabolic disease that can lead to many ocular complications such as increased Central Corneal Thickness (CCT), cataracts, and diabetic retinopathy. The aim of this study was to compare the CCT between subjects with type I and type II diabetes. Method: This was a retrospective study which included subjects with diabetes (with and without Diabetic Retinopathy (DR)) aged between 18 to 80 years old. The data collected were type and duration of diabetes mellitus, diabetes treatment, glycated hemoglobin level, visual acuity, CCT, and intra ocular pressure. Subjects were divided into subgroup (with and without DR). Statistical program (SPSS) was used to compare the central corneal thickness between the groups. Result: A total of 205 subjects with type I (n=100) and type II (n=105) diabetes were included in this study. In type 1 DM, the mean CCT was 547.06±27.3 microns in patients with diabetic retinopathy (DR) and 533.85±26.8 microns in patients without DR. In type 2 DM, the mean CCT was 542.85±39.3 microns in patients with DR and 532.44±27.4 microns in patients without DR. The CCT in type 1 diabetic patients was higher in both groups (with and without DR) than the CCT in type 2 diabetic patients in both groups (with and without DR). However, this was not statistically significant. Conclusion: The type of diabetes mellitus did not affect CCT. The presence of diabetic retinopathy in either type I or type II diabetes mellitus can affect the measurements of CCT.


2020 ◽  
Vol 5 (3) ◽  
pp. 715
Author(s):  
Sherly Muchlis Muchlis ◽  
Ardizal Rahman ◽  
Weni Helvinda

<p><em>Diabetic retinopathy (RD) is a microvascular complication that often occurs in diabetes mellitus (DM). Retinal ganglion cells (RGC) are reduced in the early stages of DM, even before microvascular abnormalities are seen on the retina. <strong>Methods</strong>: Sample of 35 eyes of non RD RD type 2 patients and 35 mild non proliferative diabetic retinopathy (NPDR) eyes After examination of ophthalmological status, perimetry and optical coherence tomography (OCT) were examined. <strong>Results:</strong> The mean MD on non-RD type 2 DM -2.74 ± 3.5 mild NPDR -5.61 ± 4.5 with p value 0.414. The average non-RD type 2 PSD DM was -3.35 ± 3.3, mild NPDR was 4.16 ± 1.4 with a p value of 0.206. The mean RGC thickness of patients with non-RD type 2 DM was 83.8 ± 7.4 µm, mild NPDR 82.7 ± 8.1 μm. There was a decrease in the value of RGC thickness, MD and PSD in patients with type 2 DM, but it was not statistically significant . <strong>Conclusion</strong>: No significant difference was found in RGC thickness in DM patients between non-RD and mild NPDR. No significant difference was found between MD and PSD in DM patients between non-RD and mild NPDR. No significant relationship was found between RGC thickness and perimetry in DM patients between non-RD and mild NPDR. </em></p>


1994 ◽  
Vol 71 (06) ◽  
pp. 731-736 ◽  
Author(s):  
M W Mansfield ◽  
M H Stickland ◽  
A M Carter ◽  
P J Grant

SummaryTo identify whether genotype contributes to the difference in PAI-1 levels in type 1 and type 2 diabetic subjects and whether genotype relates to the development of retinopathy, a Hind III restriction fragment length polymorphism and two dinucleotide repeat polymorphisms were studied. In 519 Caucasian diabetic subjects (192 type 1, 327 type 2) and 123 Caucasian control subjects there were no differences in the frequency of the Hind III restriction alleles (type 1 vs type 2 vs control: allele 1 0.397 vs 0.420 vs 0.448; allele 2 0.603 vs 0.580 vs 0.552) nor in the allelic frequency at either dinucleotide repeat sequence. In 86 subjects with no retinopathy at 15 years or more from diagnosis of diabetes and 190 subjects with diabetic retinopathy there was no difference in the frequency of Hind III restriction alleles (retinopathy present vs retinopathy absent: allele 1 0.400 vs 0.467; allele 2 0.600 vs 0.533) nor in the allelic frequencies at either dinucleotide repeat sequence. The results indicate that there is no or minimal influence of the PAI-1 gene on either PAI-1 levels or the development of diabetic retinopathy in patients with diabetes mellitus.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xujia Liu ◽  
Zehua Jiang ◽  
Guihua Zhang ◽  
Tsz Kin Ng ◽  
Zhenggen Wu

Abstract Background Genetic association of uncoupling proteins (UCPs) variants with the susceptibility of diabetic retinopathy (DR) in diabetes mellitus (DM) patients has been reported but with controversy. Here we aimed to conduct a meta-analysis to confirm the association of different UCPs variants with DR. Methods Three databases (Medline Ovid, Embase Ovid and CENTRAL) were applied in the literature search. Five genetic models, including allelic, homozygous, heterozygous, dominant and recessive models, were evaluated. Odds ratios (OR) were estimated under the random or fixed-effects models. Subgroup analyses, publication bias and sensitivity analyses were also conducted. Results Eleven studies on 2 UCPs variants (UCP1 rs1800592 and UCP2 rs659366) were included. Our meta-analysis showed that UCP1 rs1800592 was not associated with DR in type-2 DM patients, and UCP2 rs659366 also showed no association with DR. In the subgroup analyses on the stage of DR, allele G of UCP1 rs1800592 significantly increased the susceptibility of proliferative diabetic retinopathy (PDR) in type-2 DM patients in the allelic (OR = 1.26, P = 0.03) and homozygous models (OR = 1.60, P = 0.04). Subgroup analysis on ethnicity did not found any significant association of rs1800592 and rs659366 with DR. Conclusion Our meta-analysis confirmed the association of UCP1 rs1800592 variant with PDR in patients with type-2 DM, suggesting its potential as a genetic marker for PDR prediction in population screening.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Li Xu ◽  
Xu Chen ◽  
Jingfen Lu ◽  
Yan Xu ◽  
Honglin Yang ◽  
...  

Abstract Background As a subcomponent of low-density lipoprotein cholesterol (LDL-C), small dense LDL-C (sdLDL-C) has been suggested to be a better predictor of cardiovascular diseases (CVD). The aim of this research was to evaluate the predictive value of the sdLDL-C in cardiovascular events (CVs) in Chinese elderly patients with type 2 diabetes mellitus (DM). Methods A total of 386 consecutive type 2 DM patients were included into this study during December 2014 to December 2016. The serum sdLDL-C level of each subject was measured by homogeneous method. During a period of 48-month’s follow-up, the occurrence of CVs and associated clinical information were recorded. Receiver operating characteristic (ROC) curves were used to assess the predictive value of serum sdLDL-C to occurrence of major CVs. Results A total of 92 CVs occurred during the study period. The ROC curve analysis manifested that sdLDL-C in the study population had a matchable discriminatory power (AUC for sdLDL-C was 0.7366, P = 0.003). In addition, Kaplan-Meier event-free survival curves displayed an obvious increase of CVs risk for sdLDL‐C ≧ 26 mg/dL (log-rank = 9.10, P = 0.003). This phenomenon had analogous results in patients who received statins at baseline (log rank = 7.336, P = 0.007). Cox regression analysis revealed that the increase in HbA1c, glucose, LDL-C, sdLDL-C, non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B (ApoB) and the decrease in apolipoprotein AI (ApoAI) were obviously interrelated with heightened CVs risk. Multiple Cox regression demonstrated that the increase of sdLDL-C and hemoglobin A1c (HbA1c) was significantly correlated with CVs. The results of the study indicated that high sdLDL-C level (> 10 mg/dL) was a risk factor for CVs in the multivariate model (HR 1.281, 95% CI 1.225–16.032; P < 0.01). Conclusion sdLDL-C level could be an effective predictor in predicting the future CVs for Chinese elderly patients with type 2 DM and dyslipidemia.


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