The prevalence of Diabetic Retinopathy in a Tertiary Centre in Western Region, Nepal

Background: Diabetes mellitus is a multisystem disease. It has multiple complications like retinopathy, neuropathy, nephropathy, diabetes ketoacidosis, and stroke. Diabetes retinopathy (DR) is one of the blinding complications of diabetes. This study was done to find out the prevalence of diabetic retinopathy among diabetic patients attending in the outpatient department (OPD) of internal medicine, Gandaki Medical College and Teaching Hospital (GMCTHRC), Pokhara, Nepal. Materials and Methods: A hospital based cross-sectional study was performed among the 200 diabetes mellitus patients attending in the medicine OPD from 15th December 2017 to 15thDecember 2018. They were referred to eye OPD of GMC. The detailed eye examination including fundus evaluation under mydriasis was done to all the patients. The diagnosis of DR was graded using the Early Treatment Diabetic Retinopathy Study classification (ETDRS). Patients having hypertension and other retinal diseases were excluded from the study. Data analysis was done using statistical package for social sciences (SPPS) version 11.20. Results: The mean age of the patients was 63.02 ±11.8 years. In our study 60.5% of the patients were male and 39.5% were female. Diabetes retinopathy was seen in 29.5% patients, of which non proliferative diabetes retinopathy (NPDR) was present in 19.5%, proliferative diabetes retinopathy (PDR) in 9.5% and 0.5% had diabetes maculopathy. Conclusion: The prevalence of DR is quite significant in the people with diabetes. Early diagnosis and management of retinopathy will help to avoid blindness due to the diabetic retinopathy.

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Association of Retinopathy with Chronic Kidney Disease in Diabetes Mellitus

BIRDEM Medical Journal ◽

10.3329/birdem.v8i3.38123 ◽

2018 ◽

Vol 8 (3) ◽

pp. 210-214

Author(s):

Rushda Sharmin Binte Rouf ◽

SM Ashrafuzzaman ◽

Zafar Ahmed Latif

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Diabetic Retinopathy ◽

Kidney Disease ◽

Strong Association ◽

Albumin Excretion Rate ◽

Cross Sectional Study ◽

Fundus Photography ◽

Diabetic Patients ◽

Cross Sectional

Background: Diabetic retinopathy (DR) and nephropathy are two major complications of diabetes mellitus carrying significant morbidity and mortality. In this study DR was investigated in different stages of chronic kidney disease (CKD) to find out possible association of these two devastating complications.Methods: This cross-sectional study was conducted in 150 diabetic patients having CKD in BIRDEM. CKD was defined as estimated glomerular filtration rate (eGFR) of <60ml/min/1.73m2and/or urinary albumin excretion rate (UAER) >30 mg/day in at least two occasions in 3 months apart. Retinopathy was assessed by direct fundoscopic examination and confirmed by color fundus photography. Severe DR (SDR) included proliferative diabetic retinopathy, severe non-proliferative DR and maculopathy; whereas microaneurysm regarded as non-severe retinopathy.Results: Majority (68%) of the respondents had some form of retinopathy (38.35% SDR and 29.65% nonsevere). There was strong association between different levels of albuminuria (UAER) and DR (p<0.0001). On the contrary DR did not correspond with stages of CKD (P=0.349). Hypertension (79.5%) and dyslipidaemia (59%) were common co-morbidities.Conclusion: This study concluded that DR prevalence was more in nephropathy along with significant association with UAER. Whereas different stages of CKD was not associated with stages of DR . This finding focused the necessity of regular retinal examination irrespective of the stage of renal involvement.Birdem Med J 2018; 8(3): 210-214

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A study to assess the correlation between HbA1c and microalbuminuria among diabetics

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20205454 ◽

2020 ◽

Vol 8 (1) ◽

pp. 16

Author(s):

Sruthi Kare ◽

Vishwanath N. Reddy ◽

Thejdeep Mahamkali

Keyword(s):

Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Socioeconomic Development ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Duration Of Diabetes ◽

Medical College ◽

Significant Linear Correlation ◽

Patients With Diabetes

Background: India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Diabetic Nephropathy is a common consequence of long-standing diabetes mellitus. The development of diabetic nephropathy has a dramatic increase on the morbidity and mortality of patients with diabetes. Objective of this study was to evaluate the prevalence of microalbuminuria in patients with diabetes mellitus patients. Methods: This cross-sectional study was conducted on T 2 diabetes mellitus patients visiting medicine OPD of R L Jalappa hospital constituent hospital of Sri Deveraj Urs Medical College, Tamaka, Kolar from May 2016 to July 2016. A total of 60 type-2 diabetes patients were enrolled in the study.Results: Average duration of diabetes among study group was 8 years and most of the patients were between 6-10 years. In type 2DM patients, microalbuminuria and glycemic control have shown a significant linear correlation with duration of diabetes (p<0.05). Also, micro albuminuria has a significant correlation with increase in level of glycosylated haemoglobin. Conclusions: The prevalence of microalbuminuria in diabetic patients was found to be high and being a developing country; there is a dire need that microalbuminuria and HbA1c testing should be done in both, newly diagnosed as well as already diagnosed type 2DM patients as an early marker of renal risk factor.

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Awareness of Diabetic Retinopathy among patients with Diabetes Mellitus in Ilorin, Nigeria

Sudan Journal of Medical Sciences ◽

10.18502/sjms.v12i2.919 ◽

2017 ◽

Vol 12 (2) ◽

pp. 89

Author(s):

Olokoba L B ◽

Mahmud O A ◽

Adepoju F G ◽

Olokoba A B

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Clinical Information ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Female Ratio ◽

Patients With Diabetes ◽

High Level ◽

Male To Female

Background: Diabetic retinopathy is a major cause of blindness worldwide. The associated loss of productivity and quality of life of the patients with diabetic retinopathy will lead to additional socioeconomic burden. This study aims to determine the level of awareness of diabetic retinopathy among diabetic patients. Materials and Methods: This hospital-based cross sectional study, was carried out at the Diabetic and Ophthalmology clinics of University of Ilorin Teaching Hospital, Nigeria from November 2011 to July 2012. A total of 365 patients had validated, semi-structured, and interviewer-administered questionnaires to obtain information on socio-demographic characteristics, clinical information and awareness of diabetic retinopathy. Results: A total of 365 patients were enrolled, with age between 19 and 90 years, and a mean of 45.8 ±16.3 years. The male to female ratio was 1: 2.2. Ninety-nine respondents (27.1%) had no education. The majority (30.4%) had only primary education; 21.1% had tertiary; 14.5% had secondary while 6.8% had Quranic education. The mean duration of diabetes mellitus was 14.1 ±13.09 years. Of the 365 patients with diabetes mellitus, 279(76.4%) had heard that diabetes mellitus affects the eyes, while 86(23.6%) had not. Of those who had heard, 221(79.2%) heard it from health personnel, 45(16.1%) from radio/television, 25(9.0%) from internet, 23(8.2%) from books/newspapers, while 16(5.7%) heard from other sources.Conclusion: There was a high level of awareness of diabetic retinopathy amongst the patients. However, the high level of awareness of the blinding complication of diabetes mellitus did not translate to a correspondingly high level of ocular examination for diabetic retinopathy.

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A study of serum C peptide levels in newly detected diabetic patients in tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20211475 ◽

2021 ◽

Vol 8 (5) ◽

pp. 679

Author(s):

Balakrishna Teli ◽

Prabhu S. ◽

Sneha Biradar

Keyword(s):

Tertiary Care ◽

Cross Sectional Study ◽

Study Data ◽

P Value ◽

Diabetic Patients ◽

Care Hospital ◽

Cross Sectional ◽

C Peptide ◽

Medical College ◽

Endogenous Insulin

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The deficiency of C-peptide in type 1 DM or its excess in type 2 DM leads to the development of disorders which includes the cardiovascular, nervous, excretory and other systems. The present study is done to assess the serum C-peptide levels in newly detected diabetic patients and its significance in classification of diabetes and deciding about management.Methods: This cross sectional study was conducted within the hospitals attached to Bangalore medical college and research institute. 65 newly detected diabetes patients who gave consent for study and satisfy the inclusion criteria were included in the study. Data was collected using semi structured questionnaire, clinical examination and relevant investigations. Statistical analysis was performed using SPSS software. A p value of <0.05 was considered significant.Results: C-peptide levels showed that 34 (52.3%) subjects had C-peptide levels >2 followed by 10 (15.4%) subjects having 0.1 to 0.6, 9 (13.8%) subjects having 1 to 2, 6 (9.2%) subjects each having 0.6 to 1 and <0.1.Conclusions: Serum C-peptide levels are useful as an index of endogenous insulin production. Low C-peptide levels need insulin treatment due to poor insulin reserve. Majority of the subjects, who had low serum C-peptide levels also had low BMI suggesting a positive correlation between C-peptide levels and BMI.

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Cardiac autonomic neuropathy in diabetes mellitus

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175501 ◽

2017 ◽

Vol 6 (1) ◽

pp. 88 ◽

Cited By ~ 1

Author(s):

Bijaya K. Behera ◽

Vishnu K.

Keyword(s):

Diabetes Mellitus ◽

Autonomic Neuropathy ◽

Final Analysis ◽

Cross Sectional Study ◽

Cardiac Autonomic Neuropathy ◽

Diabetic Patients ◽

College Hospital ◽

Cross Sectional ◽

Medical College ◽

Patients With Diabetes

Background: The present study was conducted with an objective to study the prevalence of cardiac autonomic neuropathy (CAN) in patients with diabetes mellitus (DM) and its relation to duration, severity of DM, patient's age and BMI.Methods: This hospital based prospective study was conducted from August 2015 to September 2017, at M.K.C.G. Medical College Hospital, Berhampur, Odisha, India. Cross sectional study was design. A total number of 100 diagnosed patients of diabetes mellitus who were admitted in hospital or attended on OPD basis were taken for the study. Detailed history, clinical evaluation, laboratory investigations were carried out. The diagnosis of CAN was made by autonomic function tests. The CAN score of each patient was analysed. Database were generated based on age, duration of diabetes, severity of DM and BMI.Results: Out of 100 diabetic patients, 40 patients (23 males and 17 females) were selected for final analysis after excluding conditions causing cardiac autonomic neuropathy other than diabetes mellitus. All the patients were in the age group 21 to 70years. In the present study it was found that 57.5% of patients with DM had CAN and its incidence increased with severity of hyperglycemia, duration of DM, BMI and age of the patient.Conclusions: Cardiac autonomic neuropathy is a common and early complication of DM. Proper history taking to identify the symptoms related to CAN and performing simple autonomic tests in all patients of DM can identify cardiac autonomic neuropathy.

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Demographics and awareness of diabetic retinopathy among diabetic patients attending the vitreo-retinal service at a tertiary eye care center in Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v4i1.5844 ◽

1970 ◽

Vol 4 (1) ◽

pp. 10-16 ◽

Cited By ~ 13

Author(s):

R Thapa ◽

G Paudyal ◽

N Maharjan ◽

PS Bernstein

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Care Center ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Eye Care ◽

Cross Sectional ◽

Proliferative Stage ◽

Awareness Programs ◽

Clinically Significant

Introduction: Diabetic retinopathy (DR) is one of the leading causes of blindness in Nepal. Objective: To investigate the demographic characteristics and awareness of diabetic retinopathy among new cases of diabetes mellitus (DM) attending the vitreo-retinal service of a tertiary eye care centre in Nepal. Materials and methods: A hospital-based, cross-sectional study including all consecutive new cases of DM was carried out. Detailed demographics of the subjects and their awareness of potential ocular problems from diabetes mellitus were noted. Results: A total of 210 patients with a mean age of 57 ± 10.4 years were included. Brahmins (34.8 %) and Newars (34.3 %) were the predominant ethnic groups. Housewives (38.6 %) and office workers (18.6 %) were the major groups affected. Two-fifths (37 %) of the cases were unaware of DR and its potential for blindness. Awareness was significantly higher among literate patients (P = 0.006). Fundus evaluation was done for the first time in 48.6 %, although almost four-fifths had a duration of diabetes of five years or more. DR was found in 78 % of the cases, with 16.7 % already at the proliferative stage and about 40 % exhibiting clinically significant diabetic macular edema. Conclusion: A lack of awareness of DR coupled with a high proportion of cases already at a sight-threatening stage of retinopathy at their first presentation reflects the need for improved awareness programs to reduce the burden of blindness from DR in Nepal. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5844 NEPJOPH 2012; 4(1): 10-16

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Awareness of diabetic retinopathy among diabetic patients

Journal of the Pakistan Medical Association ◽

10.47391/jpma.897 ◽

2020 ◽

pp. 1-13

Author(s):

Amna Rizwan ◽

Abu Sufyan ◽

Asfandyar Asghar ◽

Haamid Khan ◽

Bilal Ahmad ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

General Health Status ◽

Cross Sectional ◽

Relationship Of ◽

Fundoscopic Examination ◽

Structured Questionnaire

Abstract Objectives: To assess the awareness of diabetic patients about diabetic retinopathy. Method: The cross-sectional study was conducted at the Ophthalmology Department, Fauji Foundation Hospital, Rawalpindi, Pakistan, from April 2018 to April 2019, and comprised diabetic patients of either gender aged 21-80 years. A pre-tested semi-structured questionnaire was used to collect data on socio-demographic, diabetes and diabetic retinopathy characteristics. Fundoscopic examination was done, and the presence and stage of diabetic retinopathy were documented. Data was analysed using SPSS 20. Results: Of the 132 subjects, 9(6.8%) were male and 123(93.2%) were females. The majority 64(48.5%) was aged 61-80 years. Overall, 74(56.1%) patients were aware that diabetes could affect their eyes, 57(43.2%) were never diagnosed with diabetic retinopathy, 76(57.6%) had gained information about diabetic retinopathyfrom ophthalmologists, 61(46.2%) and 29(22%) respondents reported that eyes should be examined ‘only when vision is affected’ and ‘every 6 months’ respectively, 98(74.2%) said the biggest barrier in getting eyes examined earlier was ‘lack of knowledge’, 23(17.4%) believed surgery was done for diabetic retinopathy treatment and 33(25%) believed that surgery, laser and injections all can be used. Significant relationship of diabetic retinopathy was found with duration of diabetes and the general health status (p<0.05). Conclusion: Though more than half the patients were aware that diabetes could affect the eyes, awareness of diabetic retinopathy and its consequences was low. Key Words: Awareness, Diabetes mellitus, Diabetic retinopathy, Continuous...

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Knowledge and Awareness of Diabetic Retinopathy among Diabetic Sudanese Patients, Khartoum State, Sudan, 2018

Sudan Journal of Medical Sciences ◽

10.18502/sjms.v16i4.9945 ◽

2021 ◽

Author(s):

Mohammed I. M. Ahmed

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Early Diagnosis ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Convenience Sample ◽

Diagnosis And Management ◽

Patients With Diabetes

Background: The level of awareness of diabetic retinopathy is considered an important factor for early diagnosis and management of diabetic retinopathy. This study aimed to assess the level of awareness of diabetic retinopathy among patients with diabetes mellitus in Khartoum, Sudan. Methods: This cross-sectional study was conducted among diabetic patients attending Zeenam and Abdullah Khalil Diabetic Centers between June and September 2018. A convenience sample of diabetic patients was used. Information on the sociodemographic characteristics of the patients, patients’ knowledge, compliance with available treatments, and routine eye examinations was collected using a semi-structured questionnaire. Patients were also asked about the barriers that may interfere with a regular eye examination. Results: A total of 200 patients were enrolled and 94 (47%) of them were female; 13% of the respondents were diagnosed with diabetic retinopathy, 31.5% were hypertensive, and 13.5% had hyperlipidemia. Additionally, 88.5% of the patients were aware that DM can affect their eyes and 87% had never been diagnosed with diabetic retinopathy. Although around 83% thought that diabetic retinopathy could lead to blindness, only 35.5% of them had undergone fundus examination by ophthalmologists. Moreover, 39% of the participants had irregular diabetes follow-up and 43% monthly follow-up. Only 31% went for regular eye check-up; however, their compliance with routine retinal assessment was poor, with a total of 72.5% of participants assuming that they have good vision and need not get their eyes checked up regularly. The chief factor that was related to increased awareness of diabetic retinopathy in the study was the level of education. Conclusion: Although a large proportion of diabetic patients in Khartoum are aware that diabetes mellitus can affect their eyes, regular retinal assessment of patients was poor, thus hindering early diagnosis and management.

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DIABETIC RETINOPATHY IN PATIENTS OF TYPE2 DIABETES MELLITUS WITH DIABETIC NEPHROPATHY

10.36106/ijsr/0611275 ◽

2020 ◽

pp. 1-2

Author(s):

Somedeb Gupta

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Diabetic Nephropathy ◽

Macular Edema ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Female Ratio ◽

Clinically Significant

To evaluate severity of diabetic retinopathy in patients of type 2 diabetes mellitus with diabetic nephropathy. This was a cross sectional study of 159 eyes of 80 patients aged above 40 years, diagnosed to have Type 2 DM with diabetic nephropathy. All the patients were investigated for albuminuria. The retinopathy was evaluated according to the Early Treatment Diabetes Retinopathy Study (ETDRS) classification into nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). Diabetic macular edema was characterized as clinically significant macular edema (CSME) and non-CSME. The severity of retinopathy was correlated with nephropathy. In this study, mean age of the patients were 58.26± 6.43 years and male to female ratio 1.96:1. Out of 80 diabetic patients, 22(27.5%) patients had microalbuminuria and 58 (72.5 %) had macroalbuminuria. In this study, 67 (83.7%) patients had diabetic retinopathy, out of which 14 (20.9%) patients had mild NPDR, 20 (29.9%) had moderate NPDR, 16 (23.9%) had severe NPDR, 5(7.4%) had very severe NPDR and 12 (17.9%) had PDR. In 22 patients with microalbuminuria 6 (27.3%) had mild NPDR, 4 (5.0%) had moderate NPDR and none had maculopathy. In 58 patients with macroalbuminuria, 8 (13.8%) had mild NPDR, 16 (27.6%) had moderate NPDR, 16 (27.6%) severe NPDR, 5 (8.6%) has very severe NPDR, 4(6.9%) had early PDR and 8(13.8%) had high-risk PDR, 14 (24.1%) had CSME and 4 (6.9%) had non-CSME. In our study, diabetic nephropathy patients with macroalbuminuria had more severe type of DR than patients with microalbuminuria.

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Prevalence and correlates of microvascular complications among patients with diabetes mellitus: a cross sectional study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203461 ◽

2020 ◽

Vol 8 (8) ◽

pp. 3039

Author(s):

Ashok Kumar ◽

Ardaman Singh ◽

Vikram S. Tanwar ◽

Nikhil Govil

Keyword(s):

Diabetes Mellitus ◽

Metabolic Syndrome ◽

Diabetic Retinopathy ◽

Age Of Onset ◽

Microvascular Complications ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Study Group ◽

Cross Sectional ◽

Chronic Hyperglycemia

Background: Diabetes mellitus is a metabolic disorder of multiple etiology, characterized by chronic hyperglycemia and associated with various microvascular, macrovascular and nonvascular complications leading to increasing morbidity and mortality. Microvascular complications are daibetes specific and their relation with associated comorbidities studied worldwide. To estimate the prevalence of microvascular complications in diabetic patients and to find their relation with various comorbid conditions.Methods: A total of hundred diagnosed patients of diabetes mellitus with age ranging from 18 to 75 years were enrolled in the study. Patients were assessed for the presence of microvascular complications and associated comorbidities. The effect of various comorbidities on frequency of microvascular complications was also determined. Data collected was statistically analyzed.Results: In this study, the mean age of the study group was 55.77±11.75 years. Mean age of onset of the disease was 48.89±11.50 years. Mean duration of the disease in the study group was 6.86±5.02 years. Diabetic retinopathy, neuropathy and nephropathy was found in 76%, 63% and 69% patients, respectively. Among patients with hypertension, 91.7%, 83.3%, and 81.7% cases were found to have retinopathy, neuropathy and nephropathy, respectively. The corresponding figures for those with comorbid IHD were 91.1%, 83.9% and 76.8% respectively whereas among patients with coexisting metabolic syndrome, 92.5%, 80.6%, and 79.1% were found to have retinopathy, neuropathy, and nephropathy, respectively.Conclusions: The most frequent microvascular complication reported by this study was diabetic retinopathy. comorbid conditions like hypertension, ischemic heart disease, and metabolic syndrome were associated with higher prevalence of microvascular complications in diabetic patients.

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