scholarly journals EARLY PREDICTION OF DIABETIC RETINOPATHY BY MPV AND P-LCR

2020 ◽  
pp. 58-59
Author(s):  
Rajpal Verma ◽  
Sumit Gulla ◽  
Shikha Verma
Keyword(s):  
Diabetic Retinopathy ◽  
Predictive Value ◽  
Microvascular Complications ◽  
Fasting Blood Glucose ◽  
Area Under The Curve ◽  
Large Cell ◽  
Microvascular Complication ◽  
Platelet Activity ◽  
Cross Sectional

BACKGROUND: Mean platelet volume (MPV), platelet-large cell ratio (P-LCR) are the indicators of enhanced platelet activity and can be considered as potential biomarkers for diabetic microvascular complications like diabetic retinopathy. PURPOSE: To study MPV and P-LCR in Type 2 diabetics with and without complications of diabetic retinopathy. MATERIAL AND METHODS: A cross sectional study was conducted on 75 Type 2 diabetes patients. Detailed clinical history regarding duration, and complications was taken. MPV and P-LCR were obtained using automated cell counter. Fasting blood glucose, HbA1c were also obtained. Diabetics were further categorized into patients with complications and without complications of diabetic retinopathy. Statistical analysis was performed by Statistical Package for the Social Sciences Version 16 (Chicago, IL), the Chi-square test and the unpaired t-test. The receiving operating curve (ROC) analysis was carried out. The area under the curve (AUC) was calculated. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: MPV and P-LCR were significantly (p=0.001) higher among patients with retinopathy than without retinopathy. Conclusion: MPV and P-LCR are predictive markers of diabetic microvascular complication diabetic retinopathy. They are more significant in microvascular complication diabetic retinopathy.

scholarly journals Diagnostic Accuracy of Direct Ophthalmoscopy and Non-Mydriatic Retinal Photography by Trained Optometrists for Screening of Diabetic Retinopathy

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Muhammad Saleh Memon ◽  
Shahid Ahsan ◽  
Muhammad Fahadullah ◽  
Khalida Parveen ◽  
Sumaira Salim ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Predictive Value ◽  
Fundus Photography ◽  
Slit Lamp ◽  
Reference Standard ◽  
Cross Sectional ◽  
Fundus Camera ◽  
Retinal Photography ◽  
Direct Ophthalmoscopy

Purpose:  To determine the reliability of direct ophthalmoscopy and Non-Mydriatic fundus photography for screening of Diabetic Retinopathy by optometrist. Study Design:  Observational, cross sectional. Place and Duration of Study:  Al-Ibrahim eye hospital, Karachi from October to December 2018. Material and Methods:  All individuals with type 2 diabetes of≥ 40 years of age were screened for diabetic retinopathy (DR) by two trained optometrists and an ophthalmologist. First Optometrist used Non Mydriatic Fundus Camera (NMFC) and second optometrist used direct ophthalmoscopy (DO) after dilating the pupils. Final examination was done by the Ophthalmologist with slit lamp using Volk fundus lens which was considered as reference standard. Every investigator was kept unaware of the findings of others. Results:  A total of 698 eyes of 349 respondents were screened. Ophthalmologist could not make decision by bio microscopy in 44 (6.3%) individuals as compared to 128 (18.3%) by 1st optometrist by NMFC and 142 (20.3%) by 2nd optometrist with DO. Diabetic retinopathy (DR) was diagnosed in 1493 (21.4%) with slit lamp, in 1172 (16.8%) with NMFC and in 1333 (19.1%) with DO. Sensitivity of NMFC was 76% and that of DO was 64.8%. Specificity of NMFC was 97.45% and that of DO was 96.63%.  Positive predictive value (PPV) of NMFC was 89.33% and that of DO was 84.3% Negative predictive value (NPV) of NMFC was 93.33% and that of DO was 90.7%. Conclusion:  NMFC is recommended tool for DR screening; but DO by well-trained optometrist can be reliable where neither ophthalmologist nor NMFC is available.

scholarly journals Predominant Complications of Type 2 Diabetes in Kumasi: A 4-Year Retrospective Cross-Sectional Study at a Teaching Hospital in Ghana

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 125 ◽  
Author(s):  
Max Efui Annani-Akollor ◽  
Otchere Addai-Mensah ◽  
Linda Ahenkorah Fondjo ◽  
Lorraine Sallah ◽  
Eddie-Williams Owiredu ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Teaching Hospital ◽  
Microvascular Complications ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Microvascular Complication ◽  
Sectional Study ◽  
Cross Sectional ◽  
Microvascular And Macrovascular Complications

Background and objectives: Diabetes mellitus type 2 (T2DM) has been associated with several microvascular and macrovascular complications. However, studies regarding the predominant complications of T2DM in Ghana have not been conducted. This study evaluated the prevalence and predominant complications of T2DM and assessed the sociodemographic factors associated with the development of diabetes-related complications in Kumasi, Ghana. Materials and Methods: This was a retrospective cross-sectional study conducted at Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. A total of 1600 Ghanaian T2DM adults were included in this study. Patients’ clinical data from 2012 to 2016 were retrieved from the hospital’s archive. Results: The prevalence of macrovascular and microvascular complications of T2DM was 31.8% and 35.3% respectively. The prevalence of neuropathy, nephropathy, retinopathy, sexual dysfunction, diabetic keto-acidosis (DKA), and hypoglycemia were 20.8%, 12.5%, 6.5%, 3.8%, 2.0%, and 0.8% respectively. Sexual dysfunction was significantly associated with the male gender compared to females. Being employed: Informal (aOR = 0.479, p < 0.0001), and Formal (aOR = 0.475, p = 0.0008) was associated with lower age- and sex-adjusted odds of developing T2DM-related complications while having T2DM for 5–10 years (aOR = 1.550, p = 0.0009) and more than 10 years (aOR = 2.755, p < 0.0001) was associated with increased odds of developing complications. Conclusions: Microvascular complication is the most predominant among T2DM in Kumasi, Ghana. The most prevalent T2DM-related microvascular complication in Kumasi, Ghana is neuropathy. Sexual dysfunction is associated with male compared to female T2DM patients. Being employed reduces the chance of developing T2DM-related complications while increasing DM duration increases the risk of complications.

scholarly journals Genetic variability in sodium-glucose cotransporter 2 influences glycemic control and risk for diabetic retinopathy in type 2 diabetes patients

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Jasna Klen ◽  
Katja Goričar ◽  
Vita Dolžan
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Glucose Homeostasis ◽  
Genetic Model ◽  
Microvascular Complications ◽  
Fasting Blood Glucose ◽  
Nonparametric Tests ◽  
Sodium Glucose Cotransporter

Summary Background Gluconeogenesis and renal glucose excretion in kidneys both play an important role in glucose homeostasis. Sodium-glucose cotransporter (SGLT2), coded by the SLC5A2 gene is responsible for reabsorption up to 99% of the filtered glucose in proximal tubules. SLC5A2 genetic polymorphisms were suggested to influence glucose homeostasis. We investigated if common SLC5A2 rs9934336 polymorphism influences glycemic control and risk for macro or microvascular complications in Slovenian type 2 diabetes (T2D) patients. Methods All 181 clinically well characterized T2D patients were genotyped for SLC5A2 rs9934336 G>A polymorphism. Associations with glycemic control and T2D complications were assessed with nonparametric tests and logistic regression. Results : SLC5A2 rs9934336 was significantly associated with increased fasting blood glucose levels (P<0.001) and HbA1c levels under the dominant genetic model (P=0.030). After adjustment for T2D duration, significantly higher risk for diabetic retinopathy was present in carriers of at least one polymorphic SLC5A2 rs9934336 A allele compared to non-carriers (OR=7.62; 95%CI=1.65–35.28; P=0.009). Conclusions Our pilot study suggests an important role of SLC5A2 polymorphisms in the physiologic process of glucose reabsorption in kidneys in T2D patients. This is also the first report on the association between SLC5A2 polymorphism and diabetic retinopathy.

scholarly journals Correlation of serum delta-like ligand-4 level with the severity of diabetic retinopathy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Zhu ◽  
Jingcheng Hu ◽  
Xuan Du ◽  
Qionglei Fang ◽  
Yingyi Zhou ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Microvascular Complications ◽  
Glycosylated Hemoglobin ◽  
Fasting Blood Glucose ◽  
Serum Levels ◽  
Potential Candidate ◽  
Healthy Controls ◽  
Roc Curve Analysis ◽  
The Relationship

Abstract Background Diabetic retinopathy (DR) is one of the most serious microvascular complications of type 2 diabetes mellitus (T2DM). Delta-like ligand-4 (DLL4) maintains the normal physiological microenvironment of the retina. However, the relationship between the level of DLL4 and the severity of DR remains unclear. Methods We retrospectively analyzed serum DLL4 levels and other laboratory and clinical data in 94 T2DM patients (35 patients without DR [NDR], 32 with non-proliferative DR [NPDR], 27 with proliferative DR [PDR]), and 30 healthy controls. Results The serum DLL4 level was significantly greater in the NDR group (43.38 ± 16.23 pg/mL), NPDR group (56.57 ± 25.89 pg/mL), and PDR group (74.97 ± 25.28 pg/mL) than in the healthy controls (29.9 ± 8.92 pg/mL; all p < 0.05). Among T2DM patients, the level of DLL4 increased as the severity of DR increased (p < 0.05). Logistic regression analysis demonstrated that DR was positively associated with DLL4, glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), and duration of T2DM (all p < 0.05). Consistently, receiver operating characteristic (ROC) curve analysis also indicated that DLL4 was a potential candidate biomarker for identifying the severity of DR. Conclusions T2DM patients, especially those with DR, have increased serum levels of DLL4. DLL4 may be used as a biomarker and an independent risk factor for DR, and targeting DLL4 may be a potential therapy in patients with DR.

scholarly journals ASSOCIATION OF SERUM URIC ACID AND LIPID PROFILE IN TYPE 2 DIABETIC PATIENTS WITH AND WITHOUT DIABETIC RETINOPATHY

2017 ◽  
Vol 10 (6) ◽  
pp. 112
Author(s):  
Ramesh Venkatachalam ◽  
Rathna Kumar ◽  
Ramachandran Kaliaperumal ◽  
Anitha Devaraj ◽  
Anebaracy V ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Uric Acid ◽  
Lipid Profile ◽  
Serum Uric Acid ◽  
Microvascular Complications ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Large Sample Size ◽  
Early Management

Objectives: Diabetic retinopathy (DR) is one of the microvascular complications in type 2 diabetes (T2D).  Elevated serum uric acid (SUA) has been shown to play a significant role in diabetic neuropathy and nephropathy but there is little information on retinopathy. Therefore, the present study was aimed to investigate the SUA and lipid profile in T2D patients with and without DR and the association between SUA and severity of DR.Methods: The study was conducted in the ophthalmology OPD at Sri Lakshmi Narayana Institute of Medical Sciences. The presence of T2D was confirmed by investigating fasting blood glucose level (normal limit < 110 mg/dl) in all the individuals. DR was examined by detailed dilated fundoscopic examination. Based on the fundus examination, patients were divided in to diabetes with signs of DR and those without signs of DR. Age and sex matched healthy were taken as controls. Fasting blood sugar, SUA and lipid profile were investigated for these groups. Results: The study found elevated SUA and abnormal lipid profile in DR group when compared to non-DR and control groups. We also found the significant association between SUA and severity of DR particularly in males.Conclusion: We found a significant association between SUA and severity of DR in T2D patients. Further studies with large sample size are needed to establish the role of elevated SUA and the mechanism involved in the pathogenesis of retinopathy in diabetic patients. Regular measurements of SUA level could be advised to the diabetic patients for the early management.

scholarly journals Microvascular complications and their prevalence in newly diagnosed type-2 diabetes mellitus

2019 ◽  
Vol 7 (11) ◽  
pp. 4044
Author(s):  
Angli Manhas ◽  
Meenakshi Gupta ◽  
Rameshwar S. Manhas ◽  
Dinesh Gupta ◽  
Gaurav S. Manhas
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Diseases ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
High Risk Group ◽  
Microvascular Complication ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Cross Sectional

Background: A group of metabolic diseases is ‘diabetes’ which has become a major global concern is characterized by high blood sugar. In the world about 347 million people have diabetes. Untreated long standing hyperglycemia leads to microvascular complications in newly diagnosed DM. The objective of the study was to find out prevalence of microvascular complications in newly diagnosed Type-2 diabetes mellitus.Methods: The present cross-sectional study was conducted over a period of 6 months involved 200 patients who were diagnosed with T2DM having ≤6 months duration was conducted in the out-patient department of medicine and ophthalmology at a tertiary care hospital. Informed consent was taken from all the participants who were willing to participate. Detailed history, clinical examination and relevant investigations were done to diagnose microvascular complications.Results: Maximum number of studied subjects i.e. 54% were seen in age group of 41-50 yrs. Males were 56% whereas females comprised 44%. Total of 52% of subjects were from rural background. Nephropathy was the most common microvascular complication present in 54% patients followed by neuropathy in 30% and retinopathy in 8% (NPDR in 7% and PDR in 1%) of patients.Conclusions: From the present study it has been concluded that nephropathy is the most common microvascular complication in newly diagnosed T2DM followed by neuropathy and retinopathy. Authors recommend that education of high-risk group regarding diabetes and its complications by electronic and print media is required so that they seek medical consultation at the earliest. Screening for diabetes at a younger age in view of lower average age at presentation and high prevalence of microvascular complications.

scholarly journals Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population

2021 ◽  
Vol 9 (1) ◽  
pp. e001413
Author(s):  
Jonathan Yap ◽  
Kamalesh Anbalakan ◽  
Wan Ting Tay ◽  
Daniel Ting ◽  
Carol Yim Cheung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Population Based ◽  
Cardiovascular Outcomes ◽  
Microvascular Complication ◽  
The Impact ◽  
Hba1c Levels

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

scholarly journals Inverse Cross-sectional and Longitudinal Relationships between Diabetic Retinopathy and Obstructive Sleep Apnea in Type 2 Diabetes

2021 ◽  
Vol 1 (1) ◽  
pp. 100011
Author(s):  
Jakob Grauslund ◽  
Lonny Stokholm ◽  
Anne S. Thykjær ◽  
Sören Möller ◽  
Caroline S. Laugesen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Obstructive Sleep Apnea ◽  
Diabetic Retinopathy ◽  
Sleep Apnea ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Longitudinal Relationships

scholarly journals Adherence to medication among Tunisian adults with type 2 diabetes

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Amara ◽  
R Ghammem ◽  
N Zammit ◽  
S BenFredj ◽  
J Maatoug ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
University Hospital ◽  
Health Concern ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Adherence To Medication

Abstract Introduction Diabetes mellitus is a growing public health concern. Despite compelling evidence about the effectiveness of medications, studies have indicated that less than 50% of patients achieved therapeutic targets. The aim of this study was to assess the adherence to type 2 diabetes mellitus treatment and its determinants. Methods A cross-sectional study was conducted between April and June 2017 in the Endocrinology and internal medicine departments of Farhat Hached University Hospital in Sousse, Tunisia. A convenient sample of patients who fulfilled the eligibility criteria was recruited. A pre-tested questionnaire was used to gather information. This was followed by assessing patients' adherence to diabetes medications using the eight-item Morisky Medication Adherence Scale (MMAS-8). Results A total of 330 patients with Type 2 Diabetes Mellitus participated in this study. The mean ±SD age of patients was 58.96±10.3 with female predominance (60.3%). More than half of participants were with high cardiovascular risk. In most cases (70.6 %), participants were moderate adherent. Results showed that patients become non-adherent as the disease gets older (p = 0.001). In addition patients with health insurance were significantly more adherent comparing to those who did not have it (p = 0.01). Regarding self-care practices and other metabolic risk factors' effects, our data revealed that exercising 30 minutes below than 5 times in week and poor self-management of diet were associated with low adherence (p &lt; 10-3). On the other hand, patients who have started insulin therapy were less adherent than those who had not yet (0.01). Patients with diabetic retinopathy or maculopathy were significantly more prone to be non- adherent, with respective percentage of 39.1% and 37.5%. Conclusions This study provides insights into the determinants of non-adherence, ultimately guiding the effective interventions through development of structured long-term policies not yet implemented. Key messages In most cases (70.6 %), participants were moderate adherent. Patients with diabetic retinopathy or maculopathy were significantly more prone to be non- adherent.

Mean Platelet Volume and Platelet Distribution Width Correlate with Microvascular Complications in Egyptian People with Type 2 Diabetes Mellitus

2021 ◽  
Vol 17 ◽  
Author(s):  
Mohammed I. Abd El-Ghany ◽  
Nahed Abdallah ◽  
Waleed Eldars
Keyword(s):  
Type 2 Diabetes ◽  
Mean Platelet Volume ◽  
Microvascular Complications ◽  
Fasting Blood Glucose ◽  
Vascular Complications ◽  
Platelet Distribution Width ◽  
Platelet Volume ◽  
Distribution Width ◽  
Diabetic Microvascular Complications

Background: Type 2 diabetes is a part of metabolic syndrome associated with a higher risk of vascular complications. Diabetes is characterized by changes in platelet morphology, function, and platelet hyperactivity so, it's considered a prothrombotic condition. Morbidity and mortality in people with type 2 diabetes-related to micro and macrovascular complications. Novel biomarkers are needed to identify and treat people at higher risk. Objective: The main objective of this controlled cross-sectional study was to evaluate Platelet volume indices (PVI) in subjects with type 2 diabetes with and without complications in comparison to subjects without diabetes. Methods: Hundred and thirty-five subjects aged from 35 to 60 years were subdivided into 3 groups. Group A includes 55 subjects with type 2 diabetes with complications. Group B includes 45 subjects with type 2 diabetes without complications. Group C includes 35 normal healthy subjects. Detailed clinical history was taken. Also, PVI, fasting blood glucose (FBG), hemoglobin A1c, and creatinine were obtained. Results: Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Plateletcrit (PCT), and Platelet large cell ratio (P-LCR) were significantly higher among subjects with retinopathy, nephropathy, and neuropathy than other subjects with diabetes who didn't develop complications (P<0.001). At cutoff value > 11.9 fL, MPV have diagnostic sensitivity 80% and specificity 97.8%. Whereas PDW >16.9fL has a sensitivity of 74.5% and specificity of 100% for diabetic microvascular complications (retinopathy, nephropathy, and neuropathy). Conclusion: MPV and PDW may be considered as possible biomarkers for the early detection of diabetic microvascular complications.

Sign in / Sign up

Export Citation Format

Share Document