Clinical Study on Correlation of HbA1c with Different Grades of Diabetic Retinopathy at S.V.R.R.G.G.H, Tirupati – A Hospital Based Descriptive Correlative Study

BACKGROUND Patients with diabetic retinopathy (DR) are 25 times more likely to become blind than non-diabetics.1 One of the main difficulties in establishing a relationship between the degree of hyperglycemia and the long-term complications of diabetes is the lack of a reliable and objective method for the assessment of diabetic control. Recordings of glycated proteins, serum proteins, and primary hemoglobin, have added a new dimension to glycemia assessment. HbA1c has been known to be a marker to assess the long-term control of diabetes mellitus. Few studies have shown the correlation between HbA1c and different grades of DR in the past. The purpose of this study was to determine the correlation of HbA1c with different grades of diabetic retinopathy. METHODS A descriptive correlative study was conducted among 100 diabetic patients attending the Department of Ophthalmology in S.V.R.R.G.G. Hospital, Tirupathi, for a duration of one year. Relevant history regarding their diabetes was noted. The status of diabetic retinopathy in each patient was diagnosed by comprehensive ophthalmologic examination and classified according to the early treatment diabetic retinopathy study (ETDRS) system. Patients were evaluated for their HbA1c levels. RESULTS Out of 100 patients, 43 % of participants were females, and the remaining 57 % were males. A statistically significant correlation was found between different grades of diabetic retinopathy and HbA1c levels. The other factor which had a significant correlation was the duration of diabetes and grade of retinopathy (P – value < 0.05). Age of the patient, gender of the patient, did not significantly correlate when compared in different grades of diabetic retinopathy (P - value > 0.05). CONCLUSIONS A statistically significant correlation was found between HbA1c levels and the severity of diabetic retinopathy. Higher the level of HbA1c (indicating poor glycaemic control), the more severe is the grade of DR in those set of patients. KEYWORDS Diabetic Retinopathy, HbA1c, CSME

Download Full-text

Prevalence of Diabetic Retinopathy and Correlation with HbA1c in Patients Admitted in Khyber Teaching Hospital Peshawar

Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University ◽

10.48036/apims.v17i2.451 ◽

2021 ◽

Vol 17 (2) ◽

pp. 141-145

Author(s):

Hurriya Khan ◽

Shah Muhammad Khan Jadoon ◽

Akhunzada Muhammad Aftab ◽

Haris Ashfaq ◽

Adnan Ali ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Teaching Hospital ◽

Diabetic Control ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Department Of Ophthalmology ◽

Ophthalmologic Examination ◽

Sugar Levels ◽

Hba1c Levels

Objective: To determine the prevalence of diabetic retinopathy in patients admitted in Khyber Teaching Hospital Peshawar and to correlate different stages of diabetic retinopathy with HbA1C levels. Methodology: This cross sectional study was conducted at Department of Ophthalmology, Khyber Teaching Hospital, MTI, Peshawar from December 2019 to May 2020. All patients over the age of 15 years who were diagnosed with diabetes mellitus were included in the study while patients with cataract or retinopathy due to other pathologies were excluded. All diabetic patients were admitted through outpatient department. In the ward their blood pressures were recorded and HbA1c levels were also measured. Visual acuity (VA) was checked. Screening for diabetic retinopathy was done by a consultant ophthalmologist by Optos Ultrawide Field Imaging of retina and Optical Coherence Tomography (OCT) of macula to establish stages of diabetic retinopathy and presence of diabetic macular edema respectively. Results: A total of 103 diabetic patients were included. Their retina was photographed, viewed and analyzed. Diabetic retinopathy, irrespective of the type, was found in 69 patients with a prevalence of 66.9%. Patients with lower ranges of HbA1c (below 6%) showed no evidence of DR. The clustering of majority of patients with diabetic retinopathy with HbA1c levels of 8 to 12 %, showed a significant relationship between high blood sugar levels and severity. Conclusion: In our study the higher frequency of retinopathy is alarming by considering it one of the leading causes of blindness in working class. It is highly recommended that routine ophthalmologic examination may be carried out along with optimal diabetic control.

Download Full-text

Relationship of HbA1c Values to Retinopathy, Nephropathy, and Cardiovascular

International Journal of Drug Delivery Technology ◽

10.25258/ijddt.10.1.17 ◽

2020 ◽

Vol 10 (01) ◽

pp. 127-130

Author(s):

Aaya Hamid Al-Hakeem ◽

Hadeel Haider Saleh

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Diabetic Retinopathy ◽

Glycated Hemoglobin ◽

Microvascular Complications ◽

Diabetic Patients ◽

Glycaemia Control ◽

Relationship Of ◽

Hba1c Levels

A total of 50 patients aged 35-75 years From Al-Sader educational Hospital in Al-Najaf city was studied to determine the glycated hemoglobin risk factors with value creatinine and urea in serum and diabetic nephropathy. Diabetic patient were (35-45 years old) with HbA1c 7.9 % (60mmol/mol). Patient were (45–55 years old), glycated hemoglobin (HbA1c) andgt; 8.5 %. Patients between (55–65 years were glycated hemoglobin (HbA1c) andgt;10.5 %. HbA1c levels, lipid profile, level of Creatinine and urea in serum, family history, BMI, blood pressure, disease severity, and complications were determined. Most patients developed some grade of retinopathy (examined by an ophthalmologist) except those with HbA1c 6.7% (50mmol/mol). Diabetic patients aged (55–65 years old) with HbA1c 7.6% (60mmol/mol). Patients aged 56–75 years old of glycated hemoglobin (HbA1c) andgt;7% with poor glycaemia control ≥ 126mg/dL were assessed to classify diabetic retinopathy. HbA1c and GA are associated with nephropathy separately. Retinopathy and nephropathy may respond to different aspects of hyperglycemia. The GA found as a powerful indicator of microvascular complications same as HbA1c where long-term glycaemia is the risk factor.

Download Full-text

Changes of Corneal Thickness and Intraocular Pressure in Type II Diabetic Patients

Khalij-Libya Journal of Dental and Medical Research ◽

10.47705/kjdmr.216101 ◽

2021 ◽

pp. 1-5

Author(s):

Yasmena Abdulhadi

Keyword(s):

Diabetic Retinopathy ◽

Intraocular Pressure ◽

Corneal Thickness ◽

Diabetic Control ◽

P Value ◽

Diabetic Patients ◽

Type Ii ◽

Pressure Measurements ◽

Diabetic Type ◽

Central Cornea

Aims. The purpose of the present paper is to present the results of central corneal thickness & intraocular pressure measurements in diabetic patients with or without retinopathy, and compare the results with non-diabetic control patients. Methods. Total number was 152 patients were 152 eyes The study group was divided into 3 groups as following: 50 non diabetic (control). 50 diabetic type II with no diabetic retinopathy. 52 diabetic type II patient with diabetic retinopathy. Correlation analysis was performed to assess the association between glycosylated hemoglobin levels& Intraocular pressures and retinal changes among subgroups. Results. Demographic characteristics of study and control groups were similar (P>0.05). Mean CCT 553.62 with Std deviation (14.47) in control cases and 622.27 with Std deviation (507.09) in diabetic cases which is more than control however the distinction failed to reach applied math significance were (p value= > 0.05). additionally, CCT and diabetic retinopathy association was significant were CCT in diabetic patients with no retinal changes was 563.96 Std deviation (18.85) and in diabetic patients with retinopathy was 670.45 Std deviation (717.2) and P value = 0.004 (significant). There was significant correlation between increased corneal thickness and intraocular pressure were p-value = 0.002. Conclusions. We found that the central cornea of diabetic patients is thicker when compared with non-diabetic patients. Thicker central cornea associated with diabetes mellitus should be taken into consideration while obtaining accurate intraocular pressure measurements in diabetics.

Download Full-text

Long-term HbA1c variability and the development and progression of diabetic retinopathy in subjects with type 2 diabetes

Scientific Reports ◽

10.1038/s41598-021-84150-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Han Ul Kim ◽

Sung Pyo Park ◽

Yong-Kyu Kim

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Hba1c Level ◽

Cox Proportional Hazards ◽

Progression Rate ◽

Absolute Increase ◽

Hba1c Variability ◽

Hba1c Levels

AbstractThis study aimed to investigate whether long-term HbA1c variability is associated with the development and progression of diabetic retinopathy (DR) in subjects with type 2 diabetes. We retrospectively reviewed 434 type 2 diabetes subjects without DR who underwent regular DR screening. We reviewed fundus findings, collected HbA1c levels, and calculated the coefficient of variation (CV) and average real variability (ARV) of each subject’s HbA1c level. DR was developed in 55 subjects and progressed to moderate nonproliferative DR or worse DR in 23 subjects. On Cox proportional hazards regression analysis, HbA1c ARV, but not HbA1c CV, was significantly associated with DR development. However, the association between HbA1c variability and the DR progression rate to moderate nonproliferative DR or worse DR was not significant. The inter-visit HbA1c difference value on consecutive examination predicted DR development well and more careful screening for DR is needed for those with an absolute value change of 2.05%, an absolute increase of 1.75%, and an absolute decrease of 1.45% in HbA1c levels on consecutive examination. These results indicate that long-term glucose variability measured by HbA1c ARV might be an independent risk factor for DR development in addition to the mean HbA1c level in early diabetic subjects.

Download Full-text

Stringent glycemic control is still the key to evade diabetic retinopathy.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.05.4077 ◽

2020 ◽

Vol 27 (05) ◽

pp. 1011-1016

Author(s):

Syed Munawar Alam ◽

Sagheer Ahmed ◽

Shazia Bano ◽

Shahneela Perveen

Keyword(s):

Diabetic Retinopathy ◽

Glycemic Control ◽

Proliferative Diabetic Retinopathy ◽

Study Groups ◽

Hplc Method ◽

P Value ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Institutional Review

Objectives: The aim of this study was to evaluate the major determinants of diabetic retinopathy. Study Design: Cross sectional, case control study. Setting: Department of Biochemistry, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi. Period: March 2015 to April 2016. Material & Methods: Ethical approval was taken from the Institutional Review Board of JPMC. A total of 208 people including type 2 diabetic patients and healthy control subjects; of male gender, aged between ≥30 years and ≤ 60 years were recruited and assigned to four study groups. Each group comprise of 52 individuals, depending on the ophthalmoscopy findings, i.e. healthy controls, diabetic without retinopathy (NDR), diabetic with non-proliferative diabetic retinopathy (NPDR) and diabetic with proliferative diabetic retinopathy (PDR). Fasting blood sugar was estimated using GOD-PAP method, while HbA1c was estimated by HPLC method. Data was analyzed on SPSS software version 16. Results: Diabetics with Diabetic Retinopathy had a poor glycemic control as compare to Diabetics without Diabetic Retinopathy (FBS; 109.12 ± 13.81 vs. 184.29 ± 40.07 vs. 188.6 ± 47.68 vs. 217.06 ± 62.33; p-value = 0.001) (HbA1c; 6.73 ± 0.56 vs. 8.40 ± 1.77 vs. 9.71 ± 1.85 vs. 14.91 ± 3.87; p-value = 0.001). For Diabetic Retinopathy the odds ratio of glycemic control i.e. FBS was observed as 1.019 & HbA1c was recorded as 1.561; which was statistically significant. Conclusion: Glycemic indicators; including FBS and HbA1c, are found to be the major determinants of Diabetic Retinopathy in our study.

Download Full-text

Prevalence of Dry Eye Disease in Type 2 Diabetic Patients and its Association with Diabetic Retinopathy

10.53350/pjmhs2115113269 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3269-3272

Author(s):

Darikta Dargahi Shaikh ◽

Tehmina Imdad ◽

Safdar Ali ◽

Fayaz Ali Kalhoro ◽

Sajida Parveen Shaikh ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Department Of Ophthalmology ◽

Type 2 Diabetic

Objective: To determine the prevalence of dry eye disease in type 2 diabetic patients and its correlation with retinopathy Materials and Methods: A cross-sectional study was conducted in the Department of Ophthalmology, Chandka Medical College & Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 1st April 2021 to 30th September 2021. Consecutive 100 patients with type 2 diabetes mellitus (DM) who attended outpatient department were included as per inclusion-exclusion criteria. Results: The patients were mostly female (58%) with a female-to-male ratio of 1.38:1. Most patients (43%) were under 50, followed by 51–60. (34 %). The overall mean age was 54.26 10.06. More than half (63%) of patients had diabetes for up to 5 years. The patients had a 42 percent frequency of DES. Mild, moderate, and severe dry eye were diagnosed in 21%, 16%, and 5% of individuals. Longevity and poor diabetes control exacerbated the disease. Conclusions: Type 2 DM patients' age, but not their gender, was found to be a significant predictor of DES. Dry eye was found to be more common among diabetics with poor control of their condition. In patients with type 2 diabetes, the age, but not the gender, was substantially linked to DES. Keywords: Type 2 diabetes, Dry eye disease, Diabetic retinopathy, Meibomian gland dysfunction.

Download Full-text

Altered response in renal blood flow and oxygen tension to contrast media in diabetic rats

Acta Radiologica ◽

10.1080/j.1600-0455.2003.00076.x ◽

2003 ◽

Vol 44 (3) ◽

pp. 347-353 ◽

Cited By ~ 7

Author(s):

F. Palm ◽

P.-O. Carlsson ◽

P. Hansell ◽

O. Hellberg ◽

A. Nygren ◽

...

Keyword(s):

Blood Flow ◽

Oxygen Tension ◽

Blood Glucose Concentration ◽

Diabetic Control ◽

Diabetic Rats ◽

Diabetic Patients ◽

Medullary Blood Flow ◽

Streptozotocin Diabetic Rats ◽

Altered Response

Purpose: To investigate the effect of the contrast medium (CM) iopromide on renal microcirculation and oxygen tension in non-diabetic control and streptozotocin-diabetic Wistar Furth rats. Materials and Methods: Oxygen tension was measured with Clark-type microelectrodes and blood flow with laser-Doppler flow probes. In order to differentiate between an acutely increased blood glucose concentration and a long-term diabetic state, some of the non-diabetic control rats were intravenously infused with glucose. Results: CM decreased the medullary oxygen tension in control (non-diabetic normoglycemic) rats (∼35%) but not in diabetic rats. Medullary blood flow in control rats increased after CM administration and remained elevated, while it was unchanged in the diabetic rats. In response to CM, glucose-infused control rats responded similarly to control animals in medullary oxygen tension, but similarly to diabetic rats in medullary blood flow. Contrary to in control rats, medullary oxygen tension was unchanged in diabetic animals after CM administration. Conclusion: Streptozotocin-diabetic rats have an altered response to intravenous injection of the CM iopromide compared to non-diabetic rats. The unaltered medullary oxygen tension, seen in the diabetic group after injection of CM, suggests that non-hemodynamic mechanisms are responsible for the increased frequency of renal failure commonly seen among diabetic patients.

Download Full-text

Associations Between Diabetic Retinopathy and Plasma Levels of High-sensitive C-reactive Protein or Von Willebrand Factor in Long-term Type 1 Diabetic Patients

Current Eye Research ◽

10.3109/02713683.2012.713153 ◽

2012 ◽

Vol 38 (1) ◽

pp. 174-179 ◽

Cited By ~ 15

Author(s):

Jonas Vejvad Nørskov Laursen ◽

Stine Skovbo Hoffmann ◽

Anders Green ◽

Mads Nybo ◽

Anne Katrin Sjølie ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Diabetic Patients ◽

C Reactive Protein ◽

Reactive Protein ◽

Von Willebrand ◽

Type 1 Diabetic Patients ◽

Willebrand Factor ◽

Term Type

Download Full-text

EVALUATION OF THE LONG-TERM EFFECTS OF EXPOSURE TO GREENSPACE ON TYPE 2 DIABETIC PATIENTS: CASE STUDY – TEHRAN, IRAN

ISPRS Annals of Photogrammetry Remote Sensing and Spatial Information Sciences ◽

10.5194/isprs-annals-iv-2-w5-471-2019 ◽

2019 ◽

Vol IV-2/W5 ◽

pp. 471-477

Author(s):

A. Esmaeilzadeh ◽

M. R. Delavar ◽

E. Nasli-Esfahani

Keyword(s):

Satellite Imagery ◽

Urban Policy ◽

Pearson Correlation ◽

Environmental Parameters ◽

Diabetic Patients ◽

Long Term Effects ◽

Type 2 Diabetic Patients ◽

Hba1c Levels

<p><strong>Abstract.</strong> Development of information technology and expansion of geospatial information systems have realized the planning managers and urban policy-makers’ wishes in making more informed decisions about urban management. At the same time, population growth and the provision of its health should be considered as one of the most important and remarkable issues for many researchers and medical specialists. So, in recent years there have been an increasing number of researches related to the study of effective factors such as environment parameters on the people’s health. In previous research, the long-term exposure effects of environmental parameters such as greenspace and air pollution on people’s health have been mostly ignored or access to reliable data has not been accomplished. The aim of this research is to study how the long-term exposure to greenspace surrounding the type 2 diabetes mellitus (T2DM) affects the average values of four years glycolized hemoglobin (HbA1c) levels. Moreover, in order to study the effects of the data type on reliability of the results, land-use data base (LDB) and satellite imagery have been employed. Pearson product and regression model have been used in this research for correlation and buffer analyse to calculate the degree of exposure of T2DM persons to greenspace. According to the results, negative correlation between long-term exposure to greenspace and the average values of four years HbA1c levels becomes statistically significant. Pearson correlation coefficients for the LDB (r&thinsp;=&thinsp;&minus;0.366, p&thinsp;=&thinsp;0.001) and satellite imagery (r&thinsp;=&thinsp;&minus;0.276, p&thinsp;=&thinsp;0.006) at 250-meter buffer from diabetic patients’ habitat is significant at 99% confidence level.</p>

Download Full-text

Correlation Between Ultrawide-Field Fluorescence Contrast Results and White Blood Cell Indexes in Diabetic Retinopathy

10.21203/rs.3.rs-970505/v1 ◽

2021 ◽

Author(s):

Lili Huang ◽

Lele Li ◽

Min Wang ◽

Dongmei Zhang ◽

Yu Song

Keyword(s):

Diabetic Retinopathy ◽

Blood Cell ◽

White Blood Cell ◽

Microvascular Complications ◽

White Blood Cells ◽

Diabetic Patients ◽

Microvascular Leakage ◽

Department Of Ophthalmology ◽

Liver And Kidney ◽

Fluorescence Contrast

Abstract Background: Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes. DR involves a state of systemic inflammation, and chronic inflammation can promote microvascular and macrovascular diseases in diabetic patients and accelerate disease progression. Ultrawide-field FFA (UWFA) systems are increasingly being used to examine a wider retina. To explore the correlation between the different manifestations of retinopathy under UWFA and the systemic indicators of white blood cells in patients with diabetic retinopathy .Methods: This retrospective study included the hospitalized DR patients in the Department of Ophthalmology and Endocrinology of the Affiliated Hospital 2 of Nantong University between January 2016 and March 2019. This study examined the correlations between the UWFA examination results and glycated hemoglobin (HbA1c), routine blood tests, blood coagulation function, liver and kidney function, and the neutrophil-to-lymphocyte ratio of patients with clinically diagnosed DR during hospitalization.Results: A total of 115 patients with DR (53 females and 62 males) were included (199 eyes: 102 right eyes and 97 left eyes). UWFA revealed that most eyes (77.4%) had grade 4 microvascular leakage, 52.8% had grade 0 capillary non-perfusion area, 59.3% had grade 0 neovascularization, and 92.0% had grade 0 fibrous proliferative membranes. Microvascular leakage was correlated with the NLR (r=0.186, P=0.027). Capillary non-perfusion area was correlated with the monocyte ratio (r=0.144, P=0.042) and the eosinophil ratio (r=0.123, P=0.044). Neovascularization was correlated to the monocyte ratio (r=0.324, P=0.018). Finally, the fibrous proliferative membrane was correlated to the monocyte ratio (r=0.418, P=0.002). Only the eosinophil ratio was independently associated with proliferative DR (odds ratio=1.25, 95% confidence interval: 1.04-1.51, P=0.018).Conclusion: The results of UWFA imaging in patients with DR are correlated with white blood cell population indexes. The eosinophil ratio was independently associated with proliferative DR.

Download Full-text