scholarly journals Ocular morbidity among diabetics attending the preventive ophthalmic clinic of a tertiary care institute with special reference to diabetic retinopathy

Author(s):  
Anjum B. Fazili ◽  
Rohul J. Shah ◽  
Mohd D. Mir ◽  
Asif Jasmine ◽  
Feroz A. Wani ◽  
...  

Background: Non communicable diseases have taken over previously life threatening infections in the demographic transition. As the burden of NCDs including diabetes is increasing at an alarming rate the complications related to these diseases are also increasing leading to huge morbidity. Likewise, blindness/ visual impairment due to diabetic retinopathy is now slowly and steadily replacing refractive errors and cataracts as a cause of morbidity.Methods: This cross sectional study was carried over a period of one year in an ophthalmic unit of a tertiary health care institute in which known diabetic patients were screened for diabetic retinopathy besides various modifiable and non-modifiable risk factors.Results: Overall prevalence of diabetic retinopathy in our study population was found to be 29.0%. Among various risk factors duration of diabetes, hypertension, HbA1C >6.5% and serum creatinine >1.1 mg/dl were found to be significantly associated with diabetic retinopathy.Conclusion: Regular screening for diabetic retinopathy besides prevention and strict control of risk factors is key to prevention and progression of blindness/ visual impairment due to diabetic retinopathy.

2018 ◽  
Vol 25 (08) ◽  
pp. 1256-1260
Author(s):  
Nasir Ahmad Chaudhary ◽  
Samreen Hameed ◽  
Muhammad Sultan Ul Moazzam ◽  
Sarmad Zahoor ◽  
Sidrah Latif ◽  
...  

Background: Diabetic retinopathy is one of the most common complications ofdiabetes affecting more than 1/4th of the diabetics and is also the leading cause of blindness inmany parts of the globe. Regular fundoscopic examination for screening is a routine practicein tertiary care hospitals but is not available in the primary care centers. This necessitatesthe development of a reliable screening tool which will allow for early referral of those withcomplications to the specialist centers. Objective: To determine the predictive value of HbA1clevels for the presence of diabetic retinopathy. Study Design: A cross-sectional study. Setting:Diabetic Clinic of Mayo Hospital, Lahore. Period: 04 months, January to April 2017. Method:75 diabetic patients who presented in Diabetic clinic were investigated for HbA1c levels andfundoscopic evaluation was done to detect retinal changes. Results: Out of 75 patients, 35(46.7%) were female, 40 (53.3%) were male. Median age of the patients was 51 years. All patientshad HbA1c levels more than 6.0% and 62% patients had detectable changes on fundi while therest had no detectable retinal disease despite elevated HbA1c levels. Positive predictive value(PPV) of elevated HbA1c levels for the presence of diabetic retinal changes was calculated tobe 62.66%. Conclusion: All the patients who had retinal disease on fundoscopy had HbA1clevels of more than 6.0% (PPV = 62.66) which means that elevated HbA1c levels warrant afundoscopic retinal examination to rule out diabetic retinopathy.


2020 ◽  
Vol 16 (4) ◽  
pp. 402-409 ◽  
Author(s):  
Nalini Mathala ◽  
Annapurna Akula ◽  
Sharat Hegde ◽  
Raghava Bitra ◽  
Virender Sachedev

Aim: The aim of this study is to examine the relationship between inflammatory markers, and diabetic retinopathy in type II diabetic patients. Methods: The study was a cross-sectional study included 150 type 2 diabetic patients who were divided into 3 groups. 50 in each group are divided as Diabetic patients without retinopathy (DM, n=50), nonproliferative diabetic retinopathy patients (NPDR, n=50), proliferative diabetic retinopathy patients (PDR, n=50). All the patients were subjected to complete clinical examination and laboratory investigations, such as fasting and postprandial blood glucose, serum creatinine, lipid profile tests, glycosylated haemoglobin (HbA1c), fasting insulin, serum inflammatory markers (TNF-alpha, C-reactive protein) and serum VEGF. Results: The study revealed from the multivariate analysis that age, duration and WHR (waist-hip ratio) are potent risk factors responsible for the risk of Diabetic retinopathy. Similarly, serum creatinine, CRP, TNF- alpha and VEGF are significantly higher in diabetic patients with retinopathy compared to diabetic patients without retinopathy. Conclusion: The study concluded that inflammation was associated with severe diabetic retinopathy in patients with well-controlled diabetes. A possible relationship was provided between the risk factors and biomarkers which are responsible for Diabetic retinopathy. Hence, modifying the risk factors risk and development of severe diabetic retinopathy can be reduced.


2021 ◽  
Vol 8 (13) ◽  
pp. 835-839
Author(s):  
Abhinav Marlapati ◽  
Sambuddha Ghosh ◽  
Swati Majumdar

BACKGROUND We wanted to measure and compare retinal sensitivity in central 30 degree in diabetic patients, with and without diabetic retinopathy in different stages, evaluate changes in retinal sensitivity in relation to change in HbA1c values, measure and compare GCL thickness in various stages of DR with the help of optical coherence tomography (OCT). METHODS This observational, cross-sectional study involving 100 eyes of 100 middle aged (45 - 64 years) type 2 diabetes mellitus patients (50 eyes without DR - group 1 & 50 eyes with DR - group 2) without any other ocular abnormalities was conducted in the outpatient and in-patient departments of department of ophthalmology in a tertiary care centre in West Bengal. Non-randomised sequential sampling was performed with corrected visual acuity better than or equal to 6 / 12. Fasting and postprandial blood glucose and HbA1c were estimated. Detailed ocular examination was performed using direct and indirect ophthalmoscope with + 20 D lens and slit lamp bio-microscope using + 90D lens. Retinal sensitivity was assessed by Humphrey visual field analyser by Swedish Interactive Thresholding Algorithm (SITA) standard strategy (30 - 2 programme). Spectral domain optical coherence tomography (SD OCT) was performed in all patients. SPSS version 20 has been used for the analysis. RESULTS Among DR patients, 33 had mild non-proliferative diabetic retinopathy (NPDR) (male = 15, female = 18) and 17 had moderate NPDR (male = 7, female = 10). Mean age in DR (Gr. 2) and no DR (Gr. 1) group were 52.62 and 50.74 years respectively. Mean foveal sensitivity and mean retinal sensitivity decreased significantly (P-value 0.001 and 0.002 respectively) in group 2 patients. It further decreased with increased severity of DR. Mean ganglion cell + inner plexiform layer (GC + IPL) thickness in temporal quadrant decreased in DR group compared to no DR group with significant difference between the two (P-value < 0.001). Mean retinal nerve fibre layer (RNFL) thickness was significantly reduced in DR group (P-value < 0.001). HbA1c mean in no DR (6.7 %) and DR group (8.07 %) and in mild (7.5 %) and moderate NPDR (9.17 %) shows significant association of poor control of blood sugar with severity of DR. CONCLUSIONS Retinal sensitivity decreased significantly in diabetes even without retinopathy as detected by automated perimetry. Significant decrease in retinal thickness as detected by OCT suggested that neurodegeneration occurs in diabetes even without retinopathy. So automated perimetry and OCT could be helpful in identifying persons at an early stage who are at risk of future vision loss due to diabetes. KEYWORDS Diabetic Retinopathy, Retinal Neurodegeneration, Retinal Sensitivity, Automated Perimetry, GCL + IPL Thickness, RNFL Thickness


Author(s):  
Vani G. ◽  
L. Venkat Narsimha Reddy

<p class="abstract"><strong>Background:</strong> The data on studies like lesions of the skin due to diabetes are scarce. Hence there is a need to conduct more studies on this topic of importance. The objective of the study was to study diabetic dermatological manifestations.</p><p class="abstract"><strong>Methods:</strong> A hospital based cross sectional study was carried out among 100 randomly selected patients during the study period of one year who were having diabetes as well as skin lesions due to diabetes. All diabetic patients were screened for presence of skin lesions. They were further differentiated based on the diagnosis.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 73 patients having cutaneous infections 71.2% were having fungal infections. Out of 18 having bacterial infections 38.9% were having furuncles. Out of 52 having fungal infections 63.5% were having dermatophytosis. Out of 14 cases of candidal infections, the most common was intertrigo in 35.7%. Out of 33 cases of dermatophytosis, T. cruris was the most common in 54.5%. Out of 82 patients in whom we suspected dermatoses strongly associated with diabetes the most common condition was pruritus in 36.6% of the cases.</p><p class="abstract"><strong>Conclusions:</strong> Bacterial skin infections and dermatophytosis were the most common diabetic dermatological lesions in the present study.</p>


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256145
Author(s):  
Mulu Tiruneh Asemu ◽  
Mengesha Assefa Ahunie

Background Diabetes mellitus is a complex metabolic disorder characterized by hyperglycemia that results from defects in insulin secretion, insulin action, or both. Glaucoma is the ocular complication of diabetic illness. In addition to this, retinopathy, maculopathy, ischemic optic neuropathy, extra-ocular muscle palsy, iridocyclitis, and rubeosis iridis were other complications. This study aims to determine the impact of diabetes on visual impairment and blindness among diabetic patients in Ethiopia. Methods This hospital-based cross-sectional study includes 401 samples of diabetic patients in the University of Gondar Comprehensive Specialized Hospital from January 2017 to January 2019. The multinomial logistic regression model was employed to identify significant differences among the factor variables. Results The magnitude of blindness was 32.17%, and the burden of severe visual impairment was 12.46%. Of the total patients, 120(29.9%) were have diabetic retinopathy of whom, 113(94.2%) were blind either in the right, left, or both eyes and 3 (2.5%) had severe visual impairment. One hundred twenty-six (31.42%) patients developed diabetic maculopathy of whom, 117 (92.85%) were blind either in the right or left eye, and one (0.8%) had severe visual impairment. From the whole diabetic patients, the magnitude of glaucoma was 186(46.38%), and from the patients who developed glaucoma was blind visual impairment 127(68.27%) either in the right or left eye. Thirty-eight (20.34%) had severe visual impairment. Glaucoma was significantly associated with severe visual impairment and blindness (p<0.001). Glaucoma, diabetic retinopathy, maculopathy, and type of diabetes are factors for visual impairment. Conclusion We found that visual impairment in the category of severe and blindness are frequent in Ethiopian diabetic patients. Glaucoma, diabetic retinopathy, maculopathy are the main predictive factors that determine the occurrence of blindness.


2017 ◽  
Vol 33 (12) ◽  
pp. 573
Author(s):  
Rimawati Aulia Insani Sadarang ◽  
Hari Kusnanto ◽  
Mohammad Bayu Sasongko

Predictors of severe visual impairment and blindness among diabetic patients in Special Territory of YogyakartaPurposeThe purpose of this study was to identify any predictors of severe visual impairment and blindness among diabetic patients in Daerah Istimewa Yogyakarta.MethodsThis research was a cross-sectional study by analyzing registry data from (JOGED.COM). Data included sociodemographic characteristics, diabetic status, health record, and eye diseases. The analysis was done using chi-square and simple logistic regression tests follow with semi-partial correlation, stratification tests and multilevel analysis with Generalized Estimation Equation (GEE).ResultsAs much as 1093 data were included in this study. The prevalence of severe visual impairment was 12% and blindness was 6.5%. Cataract, diabetic retinopathy and diabetes duration >10 years were statistically significant with severe visual impairment and blindness while glaucoma and hypertension only significant with severe visual impairment. The contribution of cataract in severe visual impairment (4.73%) and blindness (3.11%) was highest among eye diseases. There was modification effect of cataract to severe visual impairment and blindness by diabetes duration. Based on GEE, cataract, diabetic retinopathy and diabetes duration > 10 years was the best model to predict the occurrence of severe visual impairment and blindness.ConclusionsPredictors of severe visual impairment and blindness among diabetic patients in Daerah Istimewa Yogyakarta were the cataract, diabetic retinopathy and diabetes duration >10 years. Modification effect of cataract by diabetes duration only was significant in a model to predict blindness.


2021 ◽  
pp. 12-15
Author(s):  
Smarajit Banik ◽  
Sandip Saha ◽  
Sudipan Mitra ◽  
Ujjwal Pattanayak ◽  
Rajib Sikder ◽  
...  

Background: Diabetes mellitus is one of the important causes of morbidity and mortality. With a rise in non communicable diseases in India, diabetes has become a modern epidemic showing a rising trend in West Bengal also. A large number of diabetes patients come to the diabetes clinic of our tertiary care hospital in North Bengal Medical College and Hospital, Darjeeling, West Bengal. The large proportion of patients presenting with this condition prompted us to study the Sociodemographic and Anthropometric Prole of such patients. Methods: This was a descriptive hospital based cross sectional study involving a total of 344 diabetic patients enrolled in the diabetes clinic of a tertiary care teaching hospital from December 2019 to February 2020. A self-administered questionnaire was used to collect data and was analyzed in Microsoft excel sheet and using SPSS 20.0 software. Results: Among the 344 study participants, we found that 220 (63.95%) were males and 124 (36.05%) were females. Diabetes was more common among those aged 51-60 years 108 (31.40%). Family history was present among 188 (54.65%) of the diabetic patients. Almost 160 (46.51%) patients have diabetes 1.1 – 5 years. Hypertension was present among 216 (62.79%) patients. Almost 218 (63.37%) of the patients were overweight and 84 (24.42%) were obese. Conclusions: The diabetic patients presenting to this tertiary care hospital belong lower socioeconomic strata and having limited education in their age group. There is high proportion of obesity and hypertension among them.


2021 ◽  
pp. 1-4
Author(s):  
Biju Azariah ◽  
◽  
Geethu Babu ◽  

Work related musculoskeletal disorders (WRMSDs) have not only shown to impact the physical and pschycological comfort of the employee but also deteriorate the prospects of any production or service sector. The prevalence of WRMSDs, though studied extensively in various sectors, has been understudied in health sector, especially among doctors. This study which evaluated the prevalence and risk factors of these disorders among fifty cancer treating Radiation Oncologist at a Tertiary Care Cancer Centre in India had exposed out an alarming 68% prevalence of these disorders in the study population, with neck pain being the commonest site of these Muscloskeletal Disorders (MSDs). Several factors which could impact the development of MSDs were analysed. This higher incidence of MSDs is presumed to be because of extreme physical and mental stress of working in a high volume cancer care centre, persistent unhealthy postures during work, inadequate micropauses between works and uncomfortable working atmosphere. Adequate physician patient ratio, restricting the patient load, providing good physician friendly working environment and adequate mandatory breaks might significantly reduce the incidence of these disorders and can prevent the sagging of health care delivery.


2018 ◽  
Vol 6 (4) ◽  
pp. 104 ◽  
Author(s):  
Veena H. R. ◽  
Sribhargava Natesh ◽  
Sudhir Patil

Periodontal disease (PD), a chronic inflammatory condition characterized by destruction of the supporting tissues of the teeth, increases the risk of complications in diabetics. Diabetic retinopathy (DR) is a microvascular complication of prolonged hyperglycaemia. There appears to be a similarity in the pathogenesis of DR and PD. Hence, this study aimed to investigate the association, if any, between DR and PD, correlate the severity of DR with the severity of PD, and investigate the association between glycated haemoglobin (HbA1c), serum creatinine and periodontal variables. The periodontal status of 200 adult diabetic patients in the age group of 30–65 years with varying severity of DR was assessed. Evaluation of the severity of PD was assessed by recording clinical parameters. Haematological investigations including glycated haemoglobin (HbA1c) and serum creatinine were estimated before the initiation of treatment for DR. A statistically significant association between the mean duration of diabetes mellitus (DM) and the severity of DR and PD was found. The severity of PD was directly correlated with the severity of DR. There was a significant association between the levels of HbA1c and serum creatinine and severity of DR and PD. There could be a plausible relationship between DR and PD. Further prospective studies on a larger population with longer follow-ups are required to ascertain whether PD and its severity directly affect the progression and severity of DR.


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