scholarly journals Evaluation of HbA1c Level and Other Risk Factors in Diabetic Retinopathy: A Study of Type 2 Diabetic Patients Attending in a Tertiary Level Hospital

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 614-619 ◽  
Author(s):  
Sayama Hoque ◽  
MA Muttalib ◽  
Md Imtiajul Islam ◽  
Parvin Akter Khanam ◽  
Subhagata Choudhury

Background: Retinopathy is the leading cause of blindness in persons with diabetes. Strict monitoring and maintenance of normal blood glucose specially HbA1c and prevention of different risk factors can prevent and delay the diabetic retinopathy. The purpose of the study was to explore the factors influencing or related to the development of the diabetic retinopathy with spcial concern to the HbA1c levels.Materials and Methods: We studied 400 type 2 diabetic patients in this cross-sectional study which was conducted in the out-patient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of retinopathy through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, BMI) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's t-test, Chi-square test and logistic regression analysis to determine and quantify the association of diabetic retinopathy with various risk factors specially HbA1c.Results: 400 type 2 diabetic patients (male 166 and female 234) were studied. The prevalence of retinopathy was 12.3%; male 12.7%, female 12.0%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of retinopathy (4.2 vs 12.3 vs 18.1%;c2 = 12.529, p < .01). Logistic regression models of univariate analysis showed that the risk of retinopathy at HbA1c categories >7.0% was (OR = 3.22; 95% CI: 1.12-9.25) and the risk was strongly increased at the HbA1c categories 8% (OR = 5.07; 95% CI: 1.90-13.50). Advanced age (OR = 2.92; 95% CI: 1.44-5.91), longer duration of diabetes (OR = 3.08; 95% CI: 1.49-6.37), presence of hypertension (OR = 2.42; 95% CI: 1.14-5.16), FBG (OR = 1.139; 95% CI: 1.036-1.251), blood glucose 2 hours ABF (OR = 1.124; 95% CI: 1.046-1.207) and SBP (OR = 1.033; 95% CI: 1.011-1.056) had significant association with retinopathy.Conclusions: HbA1c categories >7.0% is an important risk factor for the development of retinopathy. Poor glycaemic control, advanced age, longer duration of diabetes, hypertension are other significant risk factors of diabetic retinopathy.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 614-619

KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 662-667 ◽  
Author(s):  
Md Imtiajul Islam ◽  
Sayama Hoque ◽  
Rehana Khatun ◽  
Md Zulfikar Ali ◽  
Md Saiful Islam ◽  
...  

Background: Macrovascular complications cause much of the serious morbidity and mortality in patients with diabetes. The aim of the study was to determine the prevalence and risk factors of different macrovascular complications among type 2 diabetic patients.Materials and Methods: We studied two fifty cases of type 2 diabetic patients in this cross-sectional study which was conducted in the out-patient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of coronary heart diseases (CHD), stroke and peripheral vascular diseases (PVD) through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, body mass index) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used logistic regression analysis to determine and quantify the association of CHD, stroke and PVD with various risk factors. Results: Two hundred and fifty cases of type 2 diabetic patients (male 129 and female 121 were studied. The prevalence of macro-vascular complications was 28.8%. Among them CHD was 21.2% (95% CI: 16.13- 26.27%), stroke in 8.4% (95% CI: 4.96-11.84%) and PVD in 7.2% (95% CI: 4-10.4%). Logistic regression models showed that macrovascular complications were more common in females; the risk increased significantly with age, longer duration of diabetes, lacking of physical exercise, presence of hypertension, HbA1c, Fasting Blood Glucose (FBG) and blood glucose 2 hours ABF.Conclusions: CHD is the most common macrovascular complication among type 2 DM patients. Advanced age, longer duration of diabetes, hypertension, poor glycaemic control, lacking of physical exercise etc. are significant risk factors of macrovascular complications in type 2 diabetic patients.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 662-667


KYAMC Journal ◽  
2017 ◽  
Vol 8 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Sayama Hoque ◽  
MA Muttalib ◽  
Md Imtiajul Islam ◽  
Parvin Akter Khanam ◽  
Nasrin Akter ◽  
...  

Background: Diabetes is the leading cause of chronic kidney disease which ultimately results end-stage renal disease (ESRD).Objectives: The purpose of the study was to explore the factors influencing or related to the development of the diabetic nephropathy with specific concern to the HbA1c (glycosylated hemoglobin) levels.Methods: Four hundred type 2 diabetic patients (male 166 and female 234) were studied and were evaluated for the presence of nephropathy through the review of their registered diabetic guide book. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's ttest,?2-test and logistic regression analysis to determine and quantify the association of diabetic nephropathy with various risk factors specially HbA1c.Results: The prevalence of nephropathy was 24.0%; male 27.1%, female 21.8%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of nephropathy (15.8 vs 22.8 vs 30.7%; ?2 = 8.590, p = .013). Logistic regression models of univariate analysis showed that the risk of nephropathy was strongly increased at the HbA1c categories 8% (OR = 2.35; 95% CI: 1.30-4.25). Advanced age (OR = 3.8; 95% CI: 2.21-6.53), longer duration of diabetes (OR = 4.05; 95% CI: 2.31-7.10), lacking of physical exercise (OR = 1.93; 95% CI: 1.20-3.10), presence of hypertension (OR = 4.62; 95% CI: 2.42-8.83), fasting blood glucose (OR = 1.139; 95% CI: 1.054-1.231), blood glucose 2 hours after breakfast (OR = 1.088; 95% CI: 1.028-1.152), systolic blood pressure (OR = 1.049; 95% CI: 1.030-1.069) and diastolic blood pressure (OR = 1.061; 95% CI: 1.026-1.097) had significant association with nephropathy.Conclusion: HbA1c categories >7.0% is an important risk factor for the development of nephropathy.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 21-26


2019 ◽  
Vol 9 (1) ◽  
pp. 2-7
Author(s):  
Prabin Kumar Karki ◽  
Santosh Timalsina ◽  
Sanat Chalise ◽  
Anita Yadav ◽  
Ashish Kumar Bhattarai

Background: Diabetes mellitus has become one of the biggest health problems of this era. The resultant microvascular and macrovascular complications add to significant amount of morbidity and mortality. Urine microalbumin is considered as an early marker for microvascular compli­cations among diabetic patients. The aim of this study was to find out the prevalence of microalbuminuria among type 2 diabetic patients attending Kathmandu Medical College and its relation with glycemic control, age, sex, duration of diabetes. Methods: A total of 208 previously diagnosed type 2 diabetic patients at­tending medical outpatient department of Kathmandu Medical College, Sinamangal were included in the study over a period of 1 year (October 2017 - September 2018). Fasting and 2-hour postprandial venous blood for blood glucose and HbA1c measurement and early morning urine sam­ple (after overnight fast) was collected for detection of microalbuminuria. Statistical analysis was done using SPSS version 23. Results: The prevalence of microalbuminuria among the study population (mean age: 54.22 ± 11.76 years, mean HbA1c: 7.62 ± 1.53 %) was 42.8%. Microalbuminuria had significant correlation with HbA1c and duration of diabetes (p<0.001), but not with age, sex and type of medication. There was positive correlation between urine microalbumin and fasting and post-prandial blood glucose. Conclusions: Our present study found high prevalence of microalbumin­uria among diabetic patients with poor glycemic control. It is suggested that tighter glycemic control with regular urine microalbumin testing should be integral part of diabetic management plan to prevent long term complications such as diabetic nephropathy


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.


2011 ◽  
Vol 5 (4) ◽  
pp. 196-200 ◽  
Author(s):  
Kazi R. Ahmed ◽  
Md N. Karim ◽  
Mohammad S. Bukht ◽  
Bishwajit Bhowmik ◽  
Amitava Acharyya ◽  
...  

2013 ◽  
Vol 14 (5) ◽  
pp. 392-399 ◽  
Author(s):  
Hui-yan Zhang ◽  
Jian-yong Wang ◽  
Gui-shuang Ying ◽  
Li-ping Shen ◽  
Zhe Zhang

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0202103 ◽  
Author(s):  
Dong-Hyun Lee ◽  
Ho Chul Yi ◽  
So Hyun Bae ◽  
Joon Hee Cho ◽  
Sang Wook Choi ◽  
...  

2016 ◽  
Vol 17 (1) ◽  
pp. 17-20
Author(s):  
Md Mostarshid Billah ◽  
Muhammad Abdur Rahim ◽  
Md Anisur Rahman ◽  
Palash Mitra ◽  
Tufayel Ahmed Chowdhury ◽  
...  

Background: Diabetic retinopathy is the commonest cause of blindness in the working age group of both developed and developing countries. It is the indicator of all micro-vascular complications of diabetes mellitus. This study was aimed to find out the frequency and pattern of diabetic retinopathy among hospitalized adult type 2 diabetic patients.Methodology: This cross-sectional study was carried out in the Department of Medicine and Endocrinology of BIRDEM General Hospital, Dhaka over a period of six months. Retinopathy was determined by fundoscopic examination in dilated pupil. Data were collected in preformed questionnaire including demographic characteristics, fundoscopic findings, and laboratory investigation reports with prior informed consent of the patients.Results: Total patients were 94, male were 52 and female were 42. Mean age of the patients was 52.2 ± 11.12 years. Hypertension was the most common (42.8%) co-morbid condition followed by dyslipidemia (33%), nephropathy (34%), neuropathy (21.3%), ischemic heart disease (9.6%) and stroke (5.3%). Study showed 37.23% Patient had good glycemic control (HbA1C <7%) and 62.77% had poor glycemic control. The frequency of retinopathy of any form was present in 36.2% patients. Among them, non-proliferative diabetic retinopathy (NPDR) was present in 78.79%, proliferative diabetic retinopathy (PDR) 6.06%, maculopathy 6.06%, both maculopathy and PDR in 9.09% diabetic patients. Among NPDR, 46.15 % was mild, 26.92% was moderate and 26.92% was severe NPDR. This study also revealed retinopathy was more with increase in duration of diabetes (66.6% vs. 17.3% p=0.01), in poorly controlled diabetic than good control (52.54% vs. 8.5%, p=0.01), those with hypertension (55% vs. 22%, p=0.02), and those having diabetic nephropathy (78.12% vs. 14.51%, p=0.01).Conclusion: This study showed frequency of diabetic retinopathy was 36.2% and among retinopathy NPDR was predominate. Poor glycemic control, increase duration of diabetes, presence of other microvascular complication i.e. nephropathy found to be significant risk factors for developing retinopathy.J MEDICINE January 2016; 17 (1) : 17-20


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