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

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.

scholarly journals Relationship between HbA1c Levels and Severity of Diabetic Retinopathy

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Saima Jamshed ◽  
Ayesha Hanif ◽  
Irfan Qayyum Malik ◽  
Nukhba Zahid ◽  
Hafiza Sadia Imtiaz
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Proliferative Diabetic Retinopathy ◽  
Hba1c Level ◽  
Vitreous Hemorrhage ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade 5

Purpose:  To determine the relationship between HbA1c and severity of retinopathy in diabetic patients. Study Design:  Cross sectional study. Place and Duration of Study:  Eye department of DHQ-UTH Gujranwala, from July 2020 to Dec 2020. Methods:  An observational cross-sectional study including 100 patients was conducted at eye department of DHQ-UTH Gujranwala from January 2018 to December 2018. After approval from institutional review board, written informed consent with demographic variables was collected from every patient. Patients of either gender between 40-80 years of age with both types I and type II diabetes were included in this study. Complete ophthalmic examination including Best Corrected Visual Acuity, slit lamp biomicroscopy, Goldmann Applanation tonometry and fundus examination carried out. Diabetic retinopathy was classified from grade 0 to grade 5. Results:  Out of 100 patients, 46 (46%) were males and 54 (54%) were females. Mean age was 60 ± 2.4 years with a range of 40 – 80 years among males and 40 – 70 years among females. Forty patients presented with grade 1 diabetic retinopathy and 4% presented with grade 5. Thirty two patients had good glycemic control while 20% had glycemic control of grade III. Patients with grade 4 diabetic retinopathy had the worst glycemic control of HbA1c level of 11.5. Conclusion:  This study concluded that patients with poor glycemic control had severe diabetic retinopathy as compared to the patients with good diabetic control. There is a direct relation between HbA1c level and severity of diabetic retinopathy. Key Words:  HbA1C, Diabetic retinopathy, Non proliferative diabetic retinopathy, Proliferative diabetic retinopathy, Vitreous hemorrhage.

scholarly journals Variation of HbA1c with Hemoglobin level: A comparative study betweenD10 Biorad (HpLC) and Nycocard (Immunochromatography) analyser.

2021 ◽  
Author(s):  
Arabinda Mohan Bhattarai ◽  
Sulochana Parajuli ◽  
Salina Pradhananga
Keyword(s):  
Glycemic Control ◽  
High Performance ◽  
Glycosylated Hemoglobin ◽  
Cross Sectional Study ◽  
Hplc Method ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Background Measurement

Abstract Background Measurement of Glycosylated Hemoglobin (HbA1c) is an established procedure in evaluating long-term glycemic control in diabetic patients. It is an index of glycemic control which is not affected by diurnal glucose fluctuations. Methods A retrospective cross sectional study was performed in the Biochemistry department of Shree Birendra Hospital, Kathmandu, Nepal involving 100 known cases of type 2 diabetes mellitus. This study was designed to study the variation of HbA1c with hemoglobin levels. HbA1c was measured by Bio-Rad D10 (HPLC method) and Nycocard (Immunochromatography method). Linear regressive analysis with correlation coefficient was used to compare HbA1c with hemoglobin levels and a p-value < 0.05 is considered statistically significant. Results There was a strong correlation of HbA1c values with Hemoglobin levels in HPLC methods p = 0.001, r = 0.6, however no such correlation was seen in Nycocard method p = 0.6, r = 0.08. Conclusion Cation-exchange high performance liquid chromatography (HPLC) is the latest method introduced in our country Nepal. Therefore, interference caused by Hemoglobin variants needs to be evaluated by methods such as HPLC. In such situations, we may consider fructosamine, glycated serum albumin or self-monitoring of blood glucose as an adjunct to HbA1C measurements.

scholarly journals Effect of glycemic control on diabetic retinopathy and diabetic macular edema: a prospective observational study

2021 ◽  
Author(s):  
Kajal Seema S. ◽  
Jayalekshmi T. ◽  
Manasa S. ◽  
Prasenna M.
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Observational Study ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Hba1c Levels

Background: The objective of the study was to examine the effect of long-term glycemic control, as measured by glycated hemoglobin levels (HbA1C), on the onset and progression of diabetic retinopathy (DR) and diabetic macular edema (DME) over a period of 10 years.Methods: Patients who were diagnosed to have type 2 diabetes mellitus participated in this cross-sectional observational study. Duration of onset of diabetes and the glycemic control status were analyzed. Fasting and postprandial blood sugar levels and HbA1C levels were tested for every participant. Diabetic retinopathy was graded as per the ETDRS guidelines using stereoscopic fundus photographs. In addition to the clinical evaluation, optical coherence tomography was done to confirm the presence of DME.Results: A total of 212 diabetic patients were enrolled in this study. One sixty-four patients (78.1%) had DR, out of which 71 patients (43.3%) had mild non proliferative diabetic retinopathy (NPDR), 42 patients (25.6%) had moderate NPDR, 31 patients (18.9%) had severe NPDR, and 20 (12.2%) had proliferative diabetic retinopathy (PDR). Fifty-nine patients with DR (36%) had DME. Duration of diabetes (14.62±6.18 vs 9.72±3.68 years, p<0.001), higher fasting blood glucose (176.79±59.13 vs 138.46±49.44 mg/dl, p<0.001) and higher HbA1c levels (8.21±1.38 vs 7.48±1.25 %, p=0.002) were significantly associated with DR.Conclusions: The stage of diabetic retinopathy rather than metabolic status is a strong predictive factor for the development of diabetic macular edema.

scholarly journals Sex-Gender Differences in Diabetic Retinopathy

Diabetology ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 1-10
Author(s):  
Sara Cherchi ◽  
Alfonso Gigante ◽  
Maria Anna Spanu ◽  
Pierpaolo Contini ◽  
Gisella Meloni ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Large Sample ◽  
Male Sex ◽  
Type 2 Diabetic

Diabetic retinopathy (DR) is one of the main causes of visual loss in individuals aged 20–64 years old. The aim of this study was to investigate, in a multicenter retrospective cross-sectional study, sex-gender difference in DR in a large sample of type 2 diabetic patients (T2DM). 20,611 T2DM regularly attending the units for the last three years were classified as having: (a) No DR (NDR), (b) nonproliferative DR (NPDR), or (c) preproliferative/proliferative DR (PPDR). DR of all grades was present in 4294 T2DM (20.8%), with a significant higher prevalence in men as compared to women (22.0% vs. 19.3% p < 0.0001). Among DR patients, both NPDR and PPDR were significantly more prevalent in men vs. women (p = 0.001 and p = 0.0016, respectively). Women had similar age and BMI, but longer diabetes duration, worse glycemic metabolic control, and more prevalence of hypertension and chronic renal failure (CRF) of any grade vs. men. No significant differences between sexes were evident in term of drug therapy for diabetes and associate pathologies. Conclusions: In this large sample of T2DM, men show higher prevalence of DR vs. women, in spite of less represented risk factors, suggesting that male sex per se might be a risk factor for DR development.

scholarly journals Systemic association of newly diagnosed proliferative diabetic retinopathy among type 2 diabetes patients presented at a tertiary eye hospital of Nepal

2015 ◽  
Vol 7 (1) ◽  
pp. 26-32
Author(s):  
R Thapa ◽  
S Bajimaya ◽  
S Sharma ◽  
B B Rai ◽  
G Paudyal
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Blood Sugar ◽  
Proliferative Diabetic Retinopathy ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Duration Of Diabetes ◽  
Case Series Study

Introduction: Proliferative diabetic retinopathy (PDR) is the leading cause of blindness among the diabetics. Objective: to study the systemic association of proliferative diabetic retinopathy. Materials and methods: A prospective, case-series study was conducted among the newly diagnosed proliferative diabetic retinopathy cases presenting at the Tilganga Institute of Ophthalmology (TIO) from January 2012 to January 2013. Diabetic retinopathy was classi¿ed using the Early Treatment Diabetic Retinopathy Study criteria. Blood pressure, fasting and postprandial blood sugar, glycosylated hemoglobin, lipid pro¿le, urine for microalbumin, urea, and creatinine were evaluated at the time of diagnosis.Results: A total of 104 type 2 diabetic patients with newly diagnosed PDR presented during the study period. Concurrent macular edema was present in 93 cases (89.42 %). The mean age was 56.96 ± 9.394 (range 32 - 78) years. Males and females comprised of 75.7 % and 24.3 % respectively. The majority (37.5 %) were involved in business, followed by government service (17.30 %), and housewives (16.34 %). Mean duration of diabetes was 11.42 ± 5.356 years (range 1 month - 26 years). Concurrent hypertension was found in 55.76 %, uncontrolled fasting and or postprandial blood sugar in 72.54 %, poor glycemic control (HbA1C > 7 %) in 73.97 %, abnormal lipid profile in 52.56 %, microalbuminuria in 67.85 %, and positive urine albumin in 50 % of the cases.Conclusion: Despite the short duration of diabetes, the concurrent hypertension, poor glycemic control, proteinuria and dyslipidemia were the main systemic associations for PDR at our clinical set-up. Awareness, identification and management of these systemic problems could reduce the rapid progression to PDR.

scholarly journals Association of high density lipoprotein levels with advancing age in type 2 diabetes patients in Tertiary Hospital.

2019 ◽  
Vol 26 (09) ◽  
pp. 1471-1476
Author(s):  
Shahzad Alam Khan ◽  
Iqra Imtiaz
Keyword(s):  
Type 2 Diabetes ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
P Value ◽  
Diabetic Patients ◽  
Adverse Cardiovascular Event ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Low Hdl

Background: HDL particles have several biological functions. Low levels of HDL-cholesterol are responsible for atherosclerotic disease. Type 2 diabetes is a metabolic disease of chronic etiology and low HDL‐cholesterol is frequent finding in diabetics. Levels of HDL with advancing age are inconsistent, few study show decline in HDL with increasing age while others show vice versa results. Objectives: Objective of this study was to establish an association between low HDL levels with advancing age in type 2 diabetic patients. Study Design: Cross sectional descriptive study. Setting: Diabetes Outpatient Department Nishtar Hospital Multan. Period: 6 months extending from March 2018 to August 2018. Materials and Methods: 145 patients with newly or previously diagnosed type 2 diabetes mellitus, age >35 years were considered for the study. Those diabetics who had family history of dyslipidemias (to rule out familial hyperlipidemias) were excluded. Study was started after acquiring permission from ethical committee. All the patients were evaluated for the HDL levels by getting a fasting lipid assay. Results: Out of 145 cases 78 (53.6%) were males while remaining 67 (46.4%) were female. Mean age of the patients was 57.27 + 6.91 years. Mean HDL level was 37.82 + 8.42. It was seen that HDL is low in 116/145 (80%) patients. Those diabetic patients who were < 60 (91 cases), HDL was noticed to be low in 67/91(73.62%) patients. Among patients >60 years (54 cases), HDL was identified to be low in 49/54(90.7%) patients. P-value was found out to be 0.012 Conclusion: Due to falling levels of HDL with advancing age in diabetic patients, there is increase in cardiovascular events in elderly diabetic patients. So the measures which tend to increase HDL level will also give protection against adverse cardiovascular event in elderly diabetics.

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