scholarly journals EFFECT OF STATIN USE ON STATUS OF DIABETIC ETINOPATHY/ DIABETIC MACULAR EDEMA IN PATIENTS OF TYPE 2 DIABETES MELLITUS

2021 ◽  
pp. 48-51
Author(s):  
Lokesh Kumar Singh ◽  
Alka Gupta ◽  
Jigyasa Srivastava
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Ldl Cholesterol ◽  
Mean Value ◽  
Department Of Ophthalmology ◽  
A Prospective Study

AIM: Effect of statin use on status of diabetic retinopathy /diabetic macular edema in patients of type 2 diabetes mellitus Check the lipid profile and detail fundus examination of all patients included in study. Effect of lipid lowering agents (statin) on Diabetic retinopathy. Asses the changes in fundus of DME patients after giving statin. MATERIALS AND METHODS:- A prospective study was conducted in the OPD of upgraded department of ophthalmology at LLRM Medical College, Meerut over the duration of from July 2019 to June 2020. The proposed study was in association of status use and hyper triglyceridemia with diabetes macular edema in patients with type-2 diabetes and diabetic retinopathy. Clearance from institution ethics committee was obtained before the study was started. An informed consent was obtained from all the patients before including them in to the study. A total of 86 patients were divided in to two equal groups randomly RESULTS:- A prospective study was conducted in the OPD of upgraded department of ophthalmology at LLRM Medical College, Meerut over the duration of from July 2019 to June 2020 and sample size of patients taken was 86 About 70.9% of the patients in this study were males and 29.1% were females. About 26.7% of the study subjects in this study had diabetes mellitus since 16 – 20 years,25.6% since more than 20 years and 20.9% since 11 – 15 years. During the baseline the CSME in left eye was present in 24.4% of the cases and during follow up,the CSME was present in 10.5% of the cases . At the time of baseline,about 64% of the patients had no CSME in right eye and 36% had CSME.At the time of follow up 87.2% of the cases had no CSME and 12.8% had CSME. In mild NPDR during follow up,44.2% had mild NPDR,24.4% had moderate NPDR and 8.1% had severe NPDR at baseline. About17.4%ofthepatientswhohadmoderateNPDRatbaselinealsohadmoderateNPDRduringfollowupvisits inlefteye. Among all the patients with mild NPDR during follow up, 54.7% had mild NPDR, 22.1% had moderate NPDR and 10.5% had severe NPDR during baseline. About 12.8% who had moderate NPDR during baseline also had moderate NPDR during follow up in right eye Mean cholesterol level during baseline was 154.13 mg/dl and during follow up was 138.12 mg/dl which was statistically significant (p=0.000). The mean triglyceride level during the baseline was 178.37 mg/dl and during follow up was 156 mg/dl which was statistically significant between the two groups (p=0.000). Mean LDL cholesterol level during the baseline was 94.99 mg/dl and during follow up was 61.24 mg/dl which was statistically significant between baseline and follow up (p=0.000). This study had shown improvement of visual acuity,decrease in macular edema and progression of diabetic retinopathy. The study also revealed that ,the statins are effective in decreasing the total cholesterol, LDL cholesterol, and triglycerides. CONCLUSION:- This study had shown improvement of visual acuity,decrease in macular edema and progression of diabetic retinopathy in patients whom statins was given The study also revealed that,the statins are effective in decreasing the total cholesterol(mean value during baseline was 154.13 mg/dl which reduces to 138.12 mg/dl during follow up),LDL cholesterol (mean value reduces from 94.99 mg/dl during baseline to 61.24 mg/dl during follow up)and triglycerides (mean value during baseline 178.37 mg/dl to 156 mg/dl during follow up).as given.

scholarly journals Ocular Risk Factors in the Primary Formation of Diabetic Macular Edema in Patients with Type 2 Diabetes Mellitus

2019 ◽  
Vol 16 (2) ◽  
pp. 225-229
Author(s):  
M. V. Pshenichnov ◽  
O. V. Kolenko ◽  
E. L. Sorokin ◽  
Ya. E. Pashentcev
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Macular Edema ◽  
Comparison Group ◽  
Mean Value ◽  
Main Group ◽  
The Mean

Purpose. Revealing of the ocular risk factors in the formation of diabetic macular edema (ME) in type 2 diabetes mellitus (DM2).Patients and methods. A 3.5-year research of 80 patients (160 eyes) with DM2 without signs of ME at the beginning of the research was performed. The main group consisted of 46 patients with ME symptoms on one or both eyes during the research period, the comparison group included 34 patients without ME symptoms to the end of the research. The initial ocular characteristics were retrospect compared in groups.Results. The mean value of the axial lengths (AL) in the eyes of the main group was 23.12 ± 0.75 mm compared to 23.82 ± 0.62 mm in the comparison group (significant difference, p < 0.01). AL was less than 23.5 mm in 66 % of the eyes in the main group and only in 22 % of the eyes in the comparison group (p < 0.01). The mean value of the initial macular retina volume in the main group was significantly higher than in the comparison group — 7.51 ± 0.22 mm3 and 7.21 ± 0.12 mm3, respectively (p < 0.01). Initial background diabetic retinopathy (DR) was noted in 73 % of the eyes in the main group, which significantly differed from the comparison group, where this index was noted only in 13 % of the eyes (p < 0.01).Conclusion. Significant ocular risk factors for the formation of ME in patients with DM2 are: the initial macular retina volume more than 7.3 mm3, the value of the AL less than 23.5 mm; the initial background DR. The use of the detected morphometric parameters of eye and retina in combination with an adequate assessment of the risk factors in human organism makes it possible to assume with high degree of probability a high risk of the primary formation of diabetic ME in patients with DM2. 

Diabetic Retinopathy Grade as a Predictive Marker of Stroke and Mortality in Type 2 Diabetes Mellitus Patients with Amputations—Seven-Year Follow-Up

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 603-P
Author(s):  
KIRAN SHAH ◽  
NATARAJAN SUNDARAM ◽  
ABHAY A. RAUT ◽  
KARTHIK RAO ◽  
NAVNEET WADHWA
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Predictive Marker

scholarly journals Assessing the changes in eye optics and visual functions in patients with insulin-dependent type 2 diabetes mellitus and their relationship with blood glucose level

2018 ◽  
Vol 11 (4) ◽  
pp. 5-13
Author(s):  
L. A. Mineeva ◽  
L. I. Balashevich ◽  
A. A. Baranov ◽  
L. B. Shubin ◽  
A. V. Kabanov
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Blood Glucose ◽  
Insulin Therapy ◽  
Glucose Level ◽  
Glycated Hemoglobin ◽  
Insulin Dependent

Purpose: To assess the changes in eye optics and visual functions depending on the level of blood sugar and glycated hemoglobin (HbA1c) in insulin-dependent type 2 diabetes mellitus (IPSD) patients with excessive body weight, who receive long-term insulin therapy.Material and methods. 32 patients (64 eyes), of which 84.4 % were women and 15.6 % men, with insulin-dependent diabetes mellitus (IPSD) but without severe general diabetic complications or concomitant eye pathology were monitored ophthalmologically for 3 years. The average duration of insulin therapy was 6 years. The average age of the patients was 60.94 ± 1.04 years; average weight, 89.1 ± 14.8 kg; average height, 163.8 ± 7.3 cm; average body mass index, 31.3 ± 4.8 kg/m2. The level of blood glucose level was determined daily with individual Accu-Check and/or OneTouch select glucometers, supplemented by scheduled monthly examinations with an endocrinologist. The level of glycated hemoglobin (HbA1c) was determined once every 3–6 months. Vision was measured by international requirements for patients with diabetes using the ETDRS (Early Treatment Diabetic Retinopathy Study Research Group) system with an ESV-3000 device. To assess lens transparency, the international Lens Opacities Classification System III (LOCS III) was used. Glycaemia level was monitored by the patients themselves with the help of individual blood glucose meters and by endocrinologists in scheduled monthly checkups. HbA1c level was measured once every 3 to 6 months.Results. Over the follow-up period, the subjective visual acuity slightly deteriorated. The anterior segment remained practically unchanged, the vitreous body showed a destruction increase, the state of the retina remained stable and conformed to that of nonproliferative diabetic retinopathy. The glucose level showed a significant drop, while the level of glycated hemoglobin HbA1c practically remained constant. The LOCS III criteria showed an increased clarity of the lens nucleus (NO), a worse transparency of cortical layers (C) deteriorated; the NC nucleus colour and P parameters of the posterior subcapsular layer practically remained the same. Conclusions. According to our data, during the development of diabetic cataracts in patients with type 2 IPSD, NO of the lens changes first followed by C changes (they become worse). With the normalization of glycemia level, diabetic retinopathy does not progress, the NO of the lens can improve, and the NC and P do not change. Normalization of glycemia is not a retarding factor for the already existing changes in C or the state of the vitreous. HbA1c is a marker and trigger for possible lens changes in patients with type 2 diabetes and prolonged insulin therapy. HbA1с is effective for tracking the dynamics of changes in the eye in these patients. The fact that the positive correlation of HbA1c and C at follow-up start changed to the negative correlation toward the end of the study indicates a disruption in lens state compensation and does not cancel the negative dynamics of state C even with a decrease in the level of HbA1c.

scholarly journals Increased Arterial Stiffness as a Predictor for Onset and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yaxin An ◽  
Yuxian Yang ◽  
Bin Cao ◽  
Huan Dong ◽  
Aihua Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Logistic Regression ◽  
Diabetic Retinopathy ◽  
Regression Analysis ◽  
Arterial Stiffness ◽  
New Onset

Introduction. Brachial–ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, has been demonstrated to be associated with type 2 diabetes mellitus (T2DM) and its vascular complications. This study was aimed at investigating the correlations of baPWV with both the presence and severity of diabetic retinopathy (DR) at baseline and at exploring the predictive role of baPWV in the new onset/progression of DR in the follow-up analysis. Methods. The prospective cohort study recruited 2,473 Chinese patients with T2DM, of whom 663 participants were finally included in the follow-up analysis. The presence and grading of DR were performed by the modified Early Treatment Diabetic Retinopathy Study. Uni- or multivariate linear and logistic regression models and Cox proportional-hazards regression analysis were conducted. Results. Of 2,473 patients with T2DM at baseline, 734 individuals were assessed to have DR and further categorized into 630 with non-sight-threatening DR (NSTDR) and 104 with STDR. In addition to the positive relationship between increased baPWV and the presence of DR, multinominal logistic regression analysis revealed that higher tertiles of baPWV were significantly related to the NSTDR (T2: OR = 1.62 (1.22, 2.15), p < 0.001 , and T3: OR = 2.58 (1.86, 3.58), p < 0.001 ) and STDR group (T3: OR = 3.87 (1.87, 8.02), p < 0.001 ). During a follow-up (mean period of 16.4 months), 111 participants had new onset/progression of DR. The cox regressions showed that high baseline baPWV was correlated with increased risk of development/progression of DR ( HR = 2.24 , 95% CI (1.24, 4.03), p = 0.007 , for T2 baPWV and HR = 2.90 , 95% CI (1.49, 5.64), p = 0.002 , for T3 baPWV) after adjustments for multiple factors. Conclusions. Our results demonstrated that baseline baPWV might be an independent predictor in new onset/worsening of DR, suggesting that increased arterial stiffness might be involved in the development of DR. Follow-up studies with a longer duration are needed.

scholarly journals Retinopathy Phenotypes in Type 2 Diabetes with Different Risks for Macular Edema and Proliferative Retinopathy

2020 ◽  
Vol 9 (5) ◽  
pp. 1433 ◽  
Author(s):  
Ines P. Marques ◽  
Maria H. Madeira ◽  
Ana L. Messias ◽  
Torcato Santos ◽  
António C-V. Martinho ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Odds Ratio ◽  
Retinal Thickness ◽  
Proliferative Retinopathy ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Our group reported that three diabetic retinopathy (DR) phenotypes: A, characterized by low microaneurysm turnover (MAT < 6) and normal central retinal thickness (CRT); B, low MAT (<6) and increased CRT, and C, high MAT (≥6), present different risks for development of macular edema (DME) and proliferative retinopathy (PDR). To test these findings, 212 persons with type 2 diabetes (T2D) and mild nonproliferative retinopathy (NPDR), one eye per person, were followed for five years with annual visits. Of these, 172 completed the follow-up or developed an outcome: PDR or DME (considering both clinically significant macular edema (CSME) and center-involved macular edema (CIME)). Twenty-seven eyes (16%) developed either CSME (14), CIME (10), or PDR (4), with one eye developing both CSME and PDR. Phenotype A showed no association with development of vision-threatening complications. Seven eyes with phenotype B and three with phenotype C developed CIME. Phenotype C showed higher risk for CSME development, with 17.41 odds ratio (p = 0.010), compared with phenotypes A + B. All eyes that developed PDR were classified as phenotype C. Levels of HbA1c and triglycerides were increased in phenotype C (p < 0.001 and p = 0.018, respectively). In conclusion, phenotype C identifies eyes at higher risk for development of CSME and PDR, whereas phenotype A identifies eyes at very low risk for vision-threatening complications.

scholarly journals Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 10 (16) ◽  
pp. 3736
Author(s):  
Ana Maria Dascalu ◽  
Anca Pantea Stoian ◽  
Alina Popa Cherecheanu ◽  
Dragos Serban ◽  
Daniel Ovidiu Costea ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Organ Specific ◽  
Post Bariatric Surgery ◽  
Early Worsening

Bariatric surgery is an emerging therapeutic approach for obese type 2 diabetes mellitus (T2DM) patients, with proven benefits for achieving target glucose control and even remission of diabetes. However, the effect of bariatric surgery upon diabetic retinopathy is still a subject of debate as some studies show a positive effect while others raise concerns about potential early worsening effects. We performed a systematic review, on PubMed, Science Direct, and Web of Science databases regarding the onset and progression of diabetic retinopathy in obese T2DM patients who underwent weight-loss surgical procedures. A total of 6375 T2DM patients were analyzed. Most cases remained stable after bariatric surgery (89.6%). New onset of diabetic retinopathy (DR) was documented in 290 out of 5972 patients (4.8%). In cases with DR at baseline, progression was documented in 50 out of 403 (12.4%) and regression in 90 (22.3%). Preoperative careful preparation of hemoglobin A1c (HbA1c), blood pressure, and lipidemia should be provided to minimize the expectation of DR worsening. Ophthalmologic follow-up should be continued regularly in the postoperative period even in the case of diabetic remission. Further randomized trials are needed to better understand the organ-specific risk factors for progression and provide personalized counseling for T2DM patients planned for bariatric surgery.

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