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 Association between Diabetic Retinopathy and Chronic Periodontitis—A Cross-Sectional Study

2018 ◽  
Vol 6 (4) ◽  
pp. 104 ◽  
Author(s):  
Veena H. R. ◽  
Sribhargava Natesh ◽  
Sudhir Patil
Keyword(s):  
Diabetic Retinopathy ◽  
Serum Creatinine ◽  
Glycated Haemoglobin ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chronic Inflammatory Condition ◽  
The Mean

Periodontal disease (PD), a chronic inflammatory condition characterized by destruction of the supporting tissues of the teeth, increases the risk of complications in diabetics. Diabetic retinopathy (DR) is a microvascular complication of prolonged hyperglycaemia. There appears to be a similarity in the pathogenesis of DR and PD. Hence, this study aimed to investigate the association, if any, between DR and PD, correlate the severity of DR with the severity of PD, and investigate the association between glycated haemoglobin (HbA1c), serum creatinine and periodontal variables. The periodontal status of 200 adult diabetic patients in the age group of 30–65 years with varying severity of DR was assessed. Evaluation of the severity of PD was assessed by recording clinical parameters. Haematological investigations including glycated haemoglobin (HbA1c) and serum creatinine were estimated before the initiation of treatment for DR. A statistically significant association between the mean duration of diabetes mellitus (DM) and the severity of DR and PD was found. The severity of PD was directly correlated with the severity of DR. There was a significant association between the levels of HbA1c and serum creatinine and severity of DR and PD. There could be a plausible relationship between DR and PD. Further prospective studies on a larger population with longer follow-ups are required to ascertain whether PD and its severity directly affect the progression and severity of DR.

scholarly journals DOES INSULIN LIKE GROWTH FACTOR-1 (IGF-1) DEFICIENCY HAVE A “PROTECTIVE” ROLE IN THE DEVELOPMENT OF DIABETIC RETINOPATHY IN THALASSEMIA MAJOR PATIENTS?

2015 ◽  
Vol 7 ◽  
pp. e2015038 ◽  
Author(s):  
Vincenzo De Sanctis
Keyword(s):  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Cross Sectional Study ◽  
Protective Role ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Patients ◽  
Italian Population ◽  
Sectional Study ◽  
Cross Sectional ◽  
Number Of Patients

Objective: This cross-sectional study was designed to give insights into relationship between Insulin-Growth-Factor 1 (IGF-1) levels and diabetic retinopathy (DR) in a sample of  thalassaemia major(TM) patients with insulin dependent diabetes mellitus (IDDM). Τhis relation was not previously evaluated, despite the fact that both diseases co-exist  in the same patient. The  study   also  describes the clinical and biochemical profile of the associated complications in TM patients with and without IDDM.   Design: A population-based cross-sectional study.  Participants:The study  includes 19 consecutive TM patients with IDDM and 31 age- and sex-matched TM patients without  IDDM who visited our out-patient clinics for an endocrine assessment Methods: An extensive medical history, with data on associated complications and current medications, was obtained. Blood samples were drawn in the morning after an overnight fast to measure the serum concentrations of IGF-1, glucose, fructosamine , free thyroxine (FT4), thyrotropin (TSH) and biochemical analysis . Serologic screening assays for hepatitis C virus seropositivity (HCVab and HCV-RNA) were also evaluated,  applying routine laboratory methods.Plasma total IGF-1 was measured by a chemiluminescent immunometric assay (CLIA) method. Ophthalmology evaluation was done by the same researcher using stereoscopic fundus biomicroscopy through dilated pupils. DR was graded using the scale developed by the Global Diabetic Retinopathy Group. Iron stores were assessed by direct and indirect methods. Results:Eighteen TM patients with IDDM (94.7 %) and 10 non-diabetic patients (32.2 %) had IGF-1 levels below the 2.5th percentile of the normal values for the Italian population. The mean serum IGF-1 concentrations were significantly lower in the diabetic versus the non-diabetic TM groups (p < 0.001). DR was present in in 4 (21 %) of 19 TM patients with IDDM and was associated with the main classical risk factors, namely inefficient glycemic control  and duration of disease but not  hypertension. Using the scale developed by the Global Diabetic Retinopathy Group, the DR in our patients was classified as non proliferative diabetic retinopathy (NPDR). Only few numbers of microaneurysms [1-3] were detected. Our data also confirm the strong association of IDDM in TM patients with other endocrine and non-endocrine complications.Conclusions: These results , although on a small number of patients, suggest a possible ‘protective’ role of low IGF-1 in the development of DR in TM patients 

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 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 Rate of glycemic control and associated factors among type two diabetes mellitus patients in Ethiopia: A cross sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251506
Author(s):  
Shambel Nigussie ◽  
Nigussie Birhan ◽  
Firehiwot Amare ◽  
Getnet Mengistu ◽  
Fuad Adem ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional

Objective To assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia. Methods A cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control. Result A total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10–4.29). The odds of poor glycemic control in patients who did not understand the pharmacist’s instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10–3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13–2.55). Conclusion The overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist’s advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.

scholarly journals Hypomagnesemia and Poor Glycemic Control Among Palestinian Type 2 Diabetic Patients: A Cross-Sectional Study

2021 ◽  
Author(s):  
Mohmmad Hamarshih ◽  
Suha Hamshari ◽  
Zaher Nazzal ◽  
Farha Abu Snobar ◽  
Rawa Mletat ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Serum Magnesium ◽  
Cross Sectional Study ◽  
Magnesium Level ◽  
Poor Glycemic Control ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of

Abstract Background: Hypomagnesemia has been shown to have a significant impact on both glycemic control and diabetes complications in type 2 Diabetes Mellitus (T2DM) patients. This study aims to assess the prevalence of hypomagnesemia in T2DM patients and find the association between serum magnesium levels and outcomes relevant to glycemic control and diabetic complications.Methods: A cross-sectional study was conducted and included 373 patients (222 males and 151 females). Serum magnesium levels were measured by the Colorimetric Endpoint Method using the Cobas C501system. Hypomagnesemia was determined to be a serum magnesium level <1.6 mg/dL. In addition, the following data were also obtained; patients' characteristics, anthropometric measurements, smoking status, HbA1c, co-morbidities, and therapeutic management. Results: Patients' mean age was 56.2 ±10.8 years, 24.6% were smokers, and most were overweight or obese. About 60% have a history of hypertension, and the majority have had diabetes for more than ten years. Their mean HbA1c level was 8.5±2. The prevalence of hypomagnesemia was 11% (95% CI: 8%-14.6%). It was found to be significantly higher among females (adjusted OR: 2.7, 95%CI: 1.2%-5.8%), patients with HbA1c ≥ 8% (adjusted OR: 2.4, 95%CI: 1.1%-5.5%), and patients with a history of diabetic retinopathy (adjusted OR: 2.7, 95%CI: 1.1%-7.1%). Conclusions: the study showed that hypomagnesemia is more prevalent in females and is associated with diabetic retinopathy and poor glycemic control. Having a sufficient magnesium level may be associated with better glycemic control and a reduced occurrence of complications.

scholarly journals Is there a relationship between body mass index and diabetic retinopathy in type II diabetic patients? A cross sectional study

2018 ◽  
Vol 17 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Zahra Sarrafan-chaharsoughi ◽  
Masoud Reza Manaviat ◽  
Nasim Namiranian ◽  
Pouria Yazdian-Anari ◽  
Masoud Rahmanian
Keyword(s):  
Body Mass Index ◽  
Diabetic Retinopathy ◽  
Body Mass ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Type Ii ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Association of Functional Health Literacy with Glycemic Control: A Cross Sectional Study in Urban Population of Bangladesh

2019 ◽  
Vol 20 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Refat Mehzabin ◽  
Kazi Jahangir Hossain ◽  
Md. Moniruzzaman ◽  
S K Jakaria Been Sayeed
Keyword(s):  
Health Literacy ◽  
Glycemic Control ◽  
Cross Sectional Study ◽  
Diabetes Duration ◽  
Functional Health ◽  
Diabetic Patients ◽  
Functional Health Literacy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Inadequate Glycemic Control

Background: Diabetes mellitus is responsible for significant morbidity and mortality around the world though there is huge development regarding its treatment. Many studies showed that functional health literacy has a great impact on diabetes outcome. The study assessed the relationship between functional health literacy and glycemic control in a sample of urban diabetic patients. Materials and methods: A cross-sectional study was conducted in Bangladesh University of Health and Science Hospital, Jurain, Dhaka from January to December 2014 that included adult diabetic patients on the basis of defined selection criteria following the purposive sampling method. Functional health literacy was assessed with the short form Test of the Functional Health Literacy in Adults (s-TOFLA). Recent HbA1c was used as a measure of glycemic control and categorized into tight, fair and inadequate glycemic control. Regression models were controlled for demographic data, diabetes duration, treatment regimen, diabetes knowledge and assistance for taking medications. Results: Following the s-TOFLA scale, 60.5% of the diabetic patients had inadequate functional health literacy of them, 89.3% had inadequate glycemic control (HbA1c>8%). And those who had adequate functional health literacy (24%) of them 68.8% had tight glycemic control (HbA1c≤7%). Overall 63.0% of the respondents had inadequate glycemic control. In linear regression model low s-TOFLA scores, longer diabetes duration and lack of assistance for taking medications were associated with higher levels of HbA1c. In fully adjusted model s-TOFLA score was the variable which was more strongly associated with HbA1c (β = -0.60, P<0.001). Conclusions: The study found that low health literacy is consistently associated with inadequate glycemic control. J MEDICINE JUL 2019; 20 (1) : 19-24

Assessment of Circulating Biomarkers in Relation to Various Stages of Diabetic Retinopathy in Type 2 Diabetic Patients-A Cross Sectional Study

2020 ◽  
Vol 16 (4) ◽  
pp. 402-409 ◽  
Author(s):  
Nalini Mathala ◽  
Annapurna Akula ◽  
Sharat Hegde ◽  
Raghava Bitra ◽  
Virender Sachedev
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Cross Sectional Study ◽  
Tnf Alpha ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Type 2 Diabetic

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.

Glycemic control and its associated factors among patients with diabetes mellitus: a cross-sectional study in Bangladesh

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hasan Mahmud Reza ◽  
Towhid Hasan ◽  
Marjia Sultana ◽  
Md. Omar Faruque
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Cross Sectional Study ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Content Type

Purpose Diabetes mellitus is becoming a growing concern worldwide. Hence, the purpose of this study is to assess the magnitude of poor glycemic control and to identify the determinants of poor glycemic control among diabetic patients attending a tertiary care hospital in Bangladesh. Design/methodology/approach This cross-sectional study was conducted among 732 diabetes patients seeking care at the outpatient department of Bangladesh Institute of Health Sciences Hospital, Dhaka, Bangladesh. Information, including glycemic status, was collected from patients’ medical records using a structured questionnaire. Findings About 87.6% of the patients were found to have poor glycemic control (glycosylated hemoglobin = 7%). Variables that were significant in bivariate analysis were put into a multivariate model where the factors associated with poor glycemic control were patients aged 41–60 years (odds ratio (OR)=2.26; 95% confidence interval (CI): 1.19–4.32, p = 0.013), suffering from diabetes for > 7 years (OR = 1.84; 95% CI: 1.12–2.99, p = 0.015), using insulin (OR = 2.34; 95% CI: 1.23–4.47; p = 0.010) or diet alone (OR = 0.20; 95% CI: 0.05–0.80, p = 0.023) as a type of diabetes treatment and proper use of medicine (OR = 0.37; 95% CI: 0.17–0.82, p = 0.015). Originality/value The high prevalence of poor glycemic control among diabetic patients is evident; therefore, strategic management and proper attention focusing on the predictors of poor glycemic control are necessary to reduce the long-term complications of diabetes.

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