scholarly journals Prevalence and associated risk factors of diabetic retinopathy and macular oedema in patients recently diagnosed with type 2 diabetes

2020 ◽  
Vol 5 (1) ◽  
pp. e000304
Author(s):  
Enrique O Graue-Hernandez ◽  
David Rivera-De-La-Parra ◽  
Sergio Hernandez-Jimenez ◽  
Carlos A Aguilar-Salinas ◽  
David Kershenobich-Stalnikowitz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Plasma Glucose ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Diabetes Duration ◽  
Haemoglobin A1c ◽  
Associated Risk Factors

ObjectiveTo determine the prevalence of diabetic retinopathy (DR) and diabetic macular oedema (DME) and their associated risk factors in patients recently diagnosed with type 2 diabetes.Methods and analysisWe carried out a cross-sectional study from April 2014 to August 2017. We included patients aged ≥18 years. Diabetes was defined as fasting plasma glucose of >7.8 mmol/L or 2-hour postload plasma glucose of >11.1 mmol/L. Non-mydriatic fundus examination with a digital-fundus camera was performed. Three images centred in the macula, optic disc and temporal to the macula were obtained and graded according to the Scottish Scale Classification of Diabetic Retinopathy.Results1232 patients (mean age 51.5 years) with a diabetes duration of 0–5 years were examined. Age-adjusted and sex-adjusted prevalence of DR and DME was 17.4% (95% CI 15.3% to 19.6%) and 6.6% (95% CI 5.4% to 8.2%), respectively. DR was associated with diabetes duration (OR per year=1.20, p<0.001), haemoglobin A1c (HbA1c) from 7.0 to 8.9 (OR=2.19, p<0.001), HbA1c≥9 (OR=2.98, p<0.001) and systolic blood pressure (SBP) (OR=1.16 per 5 mm Hg, p<0.001). DME was associated with diabetes duration (OR per year=1.26, p<0.01), HbA1c from 7.0 to 8.9 (OR=2.26, p<0.05), HbA1c≥9 (OR=2.38, p<0.01), SBP (OR per mm Hg=1.15, p<0.001) and albuminuria (OR=2.45, p<0.01).ConclusionOur study contributes to the evidence of progressive increase in DR and DME risk in early stages of diabetes, supporting the urgent need for early screening.

scholarly journals Associations with sight-threatening diabetic macular oedema among Indigenous adults with type 2 diabetes attending an Indigenous primary care clinic in remote Australia: a Centre of Research Excellence in Diabetic Retinopathy and Telehealth Eye and Associated Medical Services Network study

2021 ◽  
Vol 6 (1) ◽  
pp. e000559
Author(s):  
Laima Brazionis ◽  
Anthony Keech ◽  
Christopher Ryan ◽  
Alex Brown ◽  
David O'Neal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Renal Impairment ◽  
Macular Oedema ◽  
Primary Care Clinic ◽  
Diabetic Macular Oedema ◽  
Diabetes Duration ◽  
Care Clinic ◽  
Men And Women

ObjectiveTo identify factors associated with sight-threatening diabetic macular oedema (STDM) in Indigenous Australians attending an Indigenous primary care clinic in remote Australia.Methods and analysisA cross-sectional study design of retinopathy screening data and routinely-collected clinical data among 236 adult Indigenous participants with type 2 diabetes (35.6% men) set in one Indigenous primary care clinic in remote Australia. The primary outcome variable was STDM assessed from retinal images.ResultsAge (median (range)) was 48 (21–86) years, and known diabetes duration (median (range)) was 8.0 (0–24) years. Prevalence of STDM was high (14.8%) and similar in men and women. STDM was associated with longer diabetes duration (11.7 vs 7.9 years, respectively; p<0.001) and markers of renal impairment: abnormal estimated Glomerular Filtration Rate (eGFR) (62.9 vs 38.3%, respectively; p=0.007), severe macroalbuminuria (>300 mg/mmol) (20.6 vs 5.7%, respectively; p=0.014) and chronic kidney disease (25.7 vs 12.2%, respectively; p=0.035). Some clinical factors differed by sex: anaemia was more prevalent in women. A higher proportion of men were smokers, prescribed statins and had increased albuminuria. Men had higher blood pressure, but lower glycated Haemoglobin A1c (HbA1c) levels and body mass index, than women.ConclusionSTDM prevalence was high and similar in men and women. Markers of renal impairment and longer diabetes duration were associated with STDM in this Indigenous primary care population. Embedded teleretinal screening, known diabetes duration-based risk stratification and targeted interventions may lower the prevalence of STDM in remote Indigenous primary care services.Trial registration numberAustralia and New Zealand Clinical Trials Register: ACTRN 12616000370404.

scholarly journals Tofacitinib Ameliorates Retinal Vascular Leakage in a Murine Model of Diabetic Retinopathy with Type 2 Diabetes

2021 ◽  
Vol 22 (21) ◽  
pp. 11876
Author(s):  
Eimear M. Byrne ◽  
María Llorián-Salvador ◽  
Timothy J. Lyons ◽  
Mei Chen ◽  
Heping Xu
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
High Glucose ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Janus Kinase ◽  
Blood Retinal Barrier ◽  
Albumin Leakage

We have previously reported that inhibition of the Janus kinase 1 (JAK1) signaling ameliorates IL-17A-mediated blood-retinal barrier (BRB) dysfunction. Higher levels of IL-17A have been observed in the blood and intraocular fluids in patients with diabetic retinopathy (DR), in particular those with diabetic macular oedema. This study aimed to understand whether JAK1 inhibition could prevent BRB dysfunction in db/db mice, a model of type 2 diabetes (T2D). An in vitro study showed that high glucose treatment disrupted the junctional distribution of claudin-5 in bEnd3 cells and ZO-1 in ARPE19 cells and that tofacitinib citrate treatment prevented high glucose-mediated tight junction disruption. Albumin leakage, accompanied by increased levels of the phosphorylated form of JAK1 (pJAK1), was observed in three-month-old db/db mice. Treatment of two-and-a-half-month-old db/db mice with tofacitinib citrate for two weeks significantly reduced retinal albumin leakage and reduced pJAK1 expression. pJAK1 expression was also detected in human DR retina. Our results suggest that JAK1 inhibition can ameliorate BRB dysfunction in T2D, and JAK1 inhibitors such as tofacitinib citrate may be re-purposed for the management of diabetic macular oedema.

scholarly journals Risk Factors For Diabetic Retinopathy Progression

2015 ◽  
Vol 22 (2) ◽  
pp. 159-165
Author(s):  
Mónika Deák ◽  
Monica Lasca ◽  
Ioan Andrei Vereşiu
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Smoking Status ◽  
Diabetes Duration ◽  
Diabetes Diagnosis ◽  
Number Of Patients

AbstractBackground and Aims. There is no unanimous opinion regarding the risk factors associated with progression of diabetic retinopathy (DR). We have done a retrospective analysis of risk factors and clinical features associated with DR progression.Material and Methods. This analysis included consecutive patients with moderate non-proliferative or severe retinopathy between December 1, 2013 and May 31, 2014 who had at least two eye examinations before that period. We have collected demographic, clinical and lab data.Results. 51.28% of patients were diagnosed with moderate non-proliferative diabetic retinopathy (NPDR), 24.68% with severe NPDR and 21.05% with proliferative diabetic retinopathy. In 82.16% of cases, DR had progressed. The risk factor correlated with DR progression in the whole group was anemia; hypertension, anemia and diabetes duration were risk factors in type 1 and smoking status at diabetes diagnosis in type 2 diabetes. Total cholesterol, triglycerides, diabetes control and presence of diabetic renal disease were positively but not statistically significant correlated with DR progression.Conclusions. In our study the risk factors correlated with DR progression were hypertension, anemia and diabetes duration in type 1, respectively smoking at diabetes diagnosis in type 2 diabetes. Glycemic goals were achieved in a small number of patients.

Type 2 diabetes in Bangladesh and associated risk factors

2015 ◽  
Vol 36 (2) ◽  
pp. 174-178 ◽  
Author(s):  
S. M. Ferdous Hossain ◽  
Jahida Gulshan ◽  
Parvin Akter Khanam
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Associated Risk Factors
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