scholarly journals Deficiency of Vitamin D: Influence on Diabetic Retinopathy and Hearing Loss Among Patients with Diabetes Mellitus Type 2

2020 ◽  
Vol 10 (4) ◽  
pp. 282-286
Author(s):  
Mashhood Farooq ◽  
Syed Inamullah ◽  
Shama Mashhood ◽  
Mahmood Rana ◽  
Muhammad Fahim

Objective: To find a relationship between serum level of vitamin D with diabetic retinopathy and hearing loss in patients with diabetes mellitus type2. Study design and setting: This cross-sectional study was carried out at Ophthalmology, ENT and family physician Outpatient clinic of Mohsin Consultant Clinic Federal B Area, Karachi from study was April 2019 to December 2019. Methodology: Total 181 eligible type 2 diabetes mellitus patients. Complete ophthalmological, ENT and physical evaluation was carried out. Retinopathy and hearing status were recorded and were compared to serum 25-OH Vitamin D levels to find any association. SPSS version 23.0 was used to analyze the data. Results: Mean age of participants were found to be 60.56±7.3 (SD). When diabetic retinopathy status and hearing status was compared, non-proliferative diabetic retinopathy patients with normal hearing were 24(42.1%), with mild hearing 32(56.1%) and only 1(1.8%) with moderate-severe hearing loss was observed with P-value of <0.0001. Retinopathy status was compared with vitamin D levels. Insufficiency was seen in 14(38.9%) non-proliferative diabetic retinopathy, 2(5.6%) proliferative diabetic retinopathy patients and deficiency level was found in 33(32.7%) non-proliferative diabetic retinopathy and 15(14.9%) proliferative diabetic retinopathy patients. Level of vitamin D was compared to DR and HL status. Significantly low level of vitamin D was found with increasing severity of DR and HL with P-value <0.0001. Conclusions: Low level of vitamin D was associated with the severity of diabetic retinopathy and hearing loss in patients suffering from diabetes mellitus type2

Author(s):  
Dr Kalpana Singh ◽  
Dr Dhiraj Balwir ◽  
Dr Jeetendra Singh ◽  
Dr Ruchita Raikar

Aim: To study the relationship between severity of diabetic retinopathy (PDR or NPDR) and systemic complications of diabetes mellitus such as Neuropathy, Nephropathy or Cardiovascular manifestation as hypertension. Methods and Materials: This prospective observational study of 100 patients suffering from diabetic retinopathy. Such patients were recruited as a part of the study and further examined for any other systemic abnormality as neuropathy, nephropathy or hypertension. Statistical Analysis: Chi square test, univariate and multivariate logistic regression analysis was performed. P value < 0.05 was taken as significant. Results: Male: Female ratio of presence of diabetic retinopathy was 2.13: 1. The rate of proliferative diabetic retinopathy (PDR) was 1.47 % in persons who had diabetes for less than 5 years to 7.35 % in persons who had diabetes more than 15 years. In our study, it was seen that nephropathy was present in 35.71 % cases with PDR as compared to 8.93% of cases with Non proliferative diabetic retinopathy (NPDR). Conclusion: Our study showed that there is a significant correlation between severity of retinopathy and duration in type 2 Diabetes mellitus patients. Maximum number of patients with Diabetes mellitus having cardiovascular involvement, had hypertension (68%).In patients suffering from neuropathy as a complication of DM, maximum number of patients had diabetic foot (56%).It was seen that the severity of diabetic retinopathy had some association with presence of nephropathy. Also it can be postulated that patients with severe NPDR and PDR have high risk of developing nephropathy than patients suffering with mild and moderate NPDR. Hence it can be recommended that all patients of diabetes mellitus suffering from clinically significant neuropathy, nephropathy or hypertension as a complication of diabetes should always be screened for presence of retinopathy. Further studies with larger sample size are to be conducted to further look into this association. Keywords: Diabetic retinopathy, Diabetic nephropathy, diabetic neuropathy, complications


2019 ◽  
Vol 15 (3-4) ◽  
pp. 32-38
Author(s):  
Yu.O. Panchenko

Relevance. It’s known a number of surgical treatment methods of diabetic maculopathy (DMP) in diabetes mellitus (DM) type 2: closed subtotal vitrectomy (CSV), which according to the testimony combined with peeling of the inner limiting membrane of the retina (ILM), panretinal laser coagulation of the retina (PRLC) and phacoemulsification of cataract (PEC). Objective. To study the effectiveness of different variants of vitreoretinal interventions, complications and frequency of DMP relapses in patients with type 2 diabetes. To study the effectiveness of different options for vitreoretinal interventions by the number of relapses of the DMP for patients with type 2 DM. Materials and methods. Observed 313 patients with type 2 DM (313 eyes) with DMP and primary (group 1; n=40), moderate or severe non-proliferative diabetic retinopathy (NPDR; group 2; n=92) and proliferative diabetic retinopathy (PDR; group 3; n=181). The severity of retinopathy and DMP was established under the International clinical scale of the American Academy of Ophthalmology (2002). 78 patients underwent CSV; 85 patients in addition to performing the vitrectomy was further held peeling of ILM in the macular region; 81 patient in addition to the CSV and peeling of the ILM was performed PRLC of the retina and in 69 patients additionally to all these interventions were made PEK. For statistical processing of obtained data was performed using the program Statistica 10 (StatSoft, Inc., USA). Results. The effectiveness of surgical treatment DMP was 70.3%; in 1st month follow-up, recurrence was observed in 23.0%; 3 months – 18.2%; 6 months – from 10.2% a year monitoring – 24.9% of patients. Efficiency of used methods was as follows: CSV – 67.9%; CSV + ILM peeling – 72.9%; CSV + ILM peeling + PRLC – 71.6%; CSV + ILM peeling + PLC + PEK – 68.1%. These differences had no statistical significance (p=0.87). Methods of treatment the recurrence rate at different periods of observation did not differ significantly; only after 1 month was more frequent relapses in patients who fulfilled the maximum number of types of operations (CSV, ILM peeling, PRLC and PEK) were 31.9% (p=0.025). When using only the CSV, and in complex use of all surgeries (CSV, ILM peeling, PRLC & FEK) all recurrences were early, of which the majority (77.3 and 80.0%, respectively) had persistent. In other types of surgery, most recurrences (91-96%) were in the early persistent and late. The effectiveness of DMP surgical treatment decreased with worsening of retinopathy and was 72.5% at the primary NPDR; 77.2% at moderate or severe NPDR and 66.3% in the DPR. DPR patients had a greater frequency (33.7%) and greater severity of relapses (the number of late relapses in patients of the 3rd group was higher than that in patients of the 1st and 2nd groups in 2.3 times; p=0.001). Conclusion. The study showed the high effectiveness of all techniques that increasingly depended on the severity of retinopathy was the worst with PDR.


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Gauhar Nadri ◽  
Sandeep Saxena ◽  
Abbas Ali Mahdi ◽  
Apjit Kaur ◽  
Md. Kaleem Ahmad ◽  
...  

Abstract Background Vitamin D is a multi-functional fat-soluble metabolite essential for a vast number of physiological processes. Non-classical functions are gaining attention because of the close association of vitamin D deficiency with diabetes, and its complications. The present study was undertaken to evaluate the role of vitamin D as a biomarker for proliferative diabetic retinopathy. Methods A tertiary care center based cross-sectional study was undertaken. Seventy-two consecutive cases of type 2 diabetes mellitus were included. Diagnosis of diabetes mellitus was made using American Diabetes Association guidelines. Study subjects included: diabetes mellitus with no retinopathy (No DR) (n = 24); non-proliferative diabetic retinopathy (n = 24); and proliferative diabetic retinopathy (n = 24) and healthy controls (n = 24). All of the study subjects underwent complete ophthalmological evaluation. Best Corrected Visual Acuity (BCVA) was measured on the logarithm of the minimum angle of resolution (logMAR) scale. Serum 25-OH Vitamin D assay was done using chemiluminescent microparticle immunoassay technology. Diagnostic accuracy of vitamin D was assessed using receiver operating characteristics curve analysis and area under curve (AUC) was determined for the first time. Results ANOVA revealed a significant decrease in serum vitamin D levels with severity of diabetic retinopathy (F = 8.95, p < 0.001). LogMAR BCVA was found to increase significantly with the severity of DR (F = 112.64, p < 0.001). On AUC analysis, a cut off value of 18.6 ng/mL for Vitamin D was found to be significantly associated with proliferative diabetic retinopathy [sensitivity = 86.36% (95% CI 65.1–96.9); specificity = 81.82% (95% CI 59.7–94.7); AUC = 0.91 (excellent); and Z value = 8.17]. Conclusions Serum vitamin D levels of ≤ 18.6 ng/mL serve as sensitive and specific indicator for proliferative disease, among patients of DR.


2010 ◽  
Vol 3 (1) ◽  
Author(s):  
Irini P Chatziralli ◽  
Theodoros N Sergentanis ◽  
Petros Keryttopoulos ◽  
Nikolaos Vatkalis ◽  
Antonis Agorastos ◽  
...  

Author(s):  
Shilpa Pal ◽  
Anita Sharma ◽  
Sagar Modi

Introduction: Patients with Type 2 Diabetes Mellitus (T2DM) are at higher risk to develop depression. Depression in turn adversely affects glycaemic control and increases the risk of diabetes-related complications and mortality. There is a large variation among Indian studies on prevalence of depression in T2DM and associated risk factors. Aim: To assess the prevalence, severity, and determinants of depression among patients with T2DM. Materials and Methods: The study was conducted at a Tertiary Care Hospital during February 2018-February 2019, in North-Indian state of Uttarakhand. Study subjects were patients with T2DM, age >18 years. Based on exclusion and inclusion criterias, a total sample of 290 patients were studied. Presence of depression was assessed using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Hamilton Depression Rating Scale (HAM-D) was used to estimate the severity of depression. Unpaired t-test and Mann-Whitney U test were used to compare continuous variables between subjects with and without depression. Chi-Square test was used to analyse categorical data. Binary logistic regression analysis was used to study the association between likelihood of depression and predictor variables. Results: Among 290 (155 males and 135 females, mean age of all subjects 58.2±11.08 years) study subjects with T2DM, 64 (22.1%) were found to have depression using DSM-5 criteria. Out of these 64 patients with depression, 46 were detected to have mild depression, 14 moderate depression and 4 severe depression using HAM-D scale. Subjects with T2DM and depression had: higher proportion of females (62.5% vs. 42.0%; p-value 0.004); lower literacy level (53.1% vs. 67.3%; p-value 0.037); higher frequency of diabetic retinopathy (85.9% vs. 62.8%; p-value <0.001) and diabetic kidney disease (43.8% vs. 27.4%; p-value 0.013); higher Fasting Plasma Glucose (FPG) (217.7±94.62 vs. 190.0±76.45 mg/dL; p-value 0.040); and lower haemoglobin (10.8±2.49 vs. 11.7±2.37 gm/dL; p-value 0.010) compared to the subjects without depression. On binary logistic regression analysis, female gender (OR 2.457, 95% CI 1.368-4.413, p-value 0.003) and diabetic retinopathy (OR 3.842, 95% CI 1.788-8.255, p-value 0.001) remained significantly associated with likelihood of depression. Conclusion: Depression was present in one-fifth of the study subjects with T2DM. Majority of them had mild depression. Female gender and diabetic retinopathy were associated with increased likelihood of depression.


2017 ◽  
Vol 10 (2) ◽  
pp. 61
Author(s):  
Mohammad Shiblee Zaman ◽  
Md. Matiur Rahman ◽  
Subrata Kumar Biswas ◽  
Md. Mozammel Hoque ◽  
Khondakar Alwan Nahid

<p>The present study was aimed to evaluate the association of serum 25-hydroxy vitamin D and parathormone in 46 patients of type 2 diabetes mellitus with diabetic retinopathy [non-proliferative, (n=27); proliferative (n=19)]. Twenty one diabetic patients without retinopathy were taken as control. Serum 25-hydroxy vitamin D and intact parathyroid hormone were measured by chemiluminescence microparticle immunoassay. Concentration of 25-hydroxy vitamin D differed significantly among groups (p=0.018) and it was significantly lower in proliferative diabetic retinopathy than no diabetic retinopathy (p=0.003). Logistic regression analysis revealed that vitamin D deficiency [25-hydroxy vitamin D &lt;20 ng/mL] was indepen-dently associated with development of diabetic retinopathy (p=0.007, OR 20.90, 95%CI 2.33-187.23). In conclusion, vitamin D deficiency is associated with diabetic retinopathy complicating type 2 diabetes mellitus.</p>


2013 ◽  
Vol 5 (1) ◽  
pp. 28-32 ◽  
Author(s):  
D Karimsab ◽  
SK Razak

Introduction: Normal bacterial flora may be altered by a variety of factors. Objective: To study the aerobic bacterial conjunctival flora in patients with diabetes mellitus and to find its clinical significance by comparing the results to the conjunctival flora of non-diabetic subjects. Materials and methods: A total of 75 diabetic patients were included as cases and 25 nondiabetics as controls to compare the results. Specimens for the study of conjunctival flora were taken by rubbing sterile cotton-tipped swabs to the inferior palbebral conjunctiva. The conjunctival culture report of the patients with diabetic mellitus was compared to that of nondiabetic subjects. Results: Positive conjunctival cultures were seen in a higher percentage of patients with diabetes (unilateral and bilateral positive conjunctival cultures 34.66 % and 58.66 % respectively) compared to that in non-diabetic controls (unilateral and bilateral positive conjunctival cultures 24 % and 16 % respectively). Diabetics showed a higher proportion of coagulase negative staphylococci (45.33 %), compared to the non-diabetic group (16 %). Among the diabetic patients, positive conjunctival cultures were detected more frequently in those with diabetic retinopathy compared to those without retinopathy. A higher proportions of bilateral positive conjunctival cultures were seen in cases with proliferative diabetic retinopathy (38.63 %) in comparison to patients with no retinopathy and different stages of non-proliferative diabetic retinopathy. Conclusion: The conjunctival floral pattern with increased bacteria in diabetics is a predominant cause of many diabetes-related ocular infections. The presence of diabetic retinopathy is an indicator for increased colonization of conjunctiva, and its severity correlates with the severity of diabetic retinopathy. Nepal J Ophthalmol 2013; 5(9):28-32 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7818


Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 658
Author(s):  
Ieva Jurgeleviciene ◽  
Daiva Stanislovaitiene ◽  
Vacis Tatarunas ◽  
Marius Jurgelevicius ◽  
Dalia Zaliuniene

Background and objectives: Glycation occurs in a variety of human tissues and organs. Knowledge about the relationship between predictive biochemical factors such as absorption of glycated nail proteins and severity of type 2 diabetes mellitus (DM) and diabetic retinopathy (DR) remains limited. Materials and Methods: The study group consisted of patients with type 2 DM and DR (n = 32) and a control group (n = 28). Each patient underwent a comprehensive ophthalmic examination. The glycation process in nail clippings was evaluated in stages of in vitro glycation and deglycation stages. ATR–FTIR spectroscopy was used to calculate the infrared absorption in the region of interest. The absorption of solutions with nail clippings was evaluated by NanoDrop spectrophotometry. Absorption spectra differences before and after the exposure to fructosamine 3-kinase were compared between DM patients with DR and the control group. Results: The absorption of glycated nail protein greater than 83.00% increased the chance of developing DM and DR (OR = 15.909, 95% CI 3.914–64.660, p < 0.001). Absorption of glycated nail protein by ATR–FTIR spectroscopy in patients with DM and DR in vitro glycation was statistically significantly higher than in the control group; also absorption of solution with nails by NanoDrop spectroscopy was statistically significantly higher than in controls in vitro glycation and in vitro deglycation. After exposure to fructosamine 3-kinase, absorption of nail protein in DM + severe/proliferative DR group was statistically significantly lower in comparison with DM + mild/moderate group DR. Conclusions: Evaluation of glycated nail protein could be applied to evaluate the risk of having DM and for long-term observation of DM control.


Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 164
Author(s):  
Wojciech Matuszewski ◽  
Angelika Baranowska-Jurkun ◽  
Magdalena M. Stefanowicz-Rutkowska ◽  
Robert Modzelewski ◽  
Janusz Pieczyński ◽  
...  

Background and Objectives: The global epidemic of diabetes, especially type 2 (DM2), is related to lifestyle changes, obesity, and the process of population aging. Diabetic retinopathy (DR) is the most serious complication of the eye caused by diabetes. The aim of this research was to assess the prevalence of diabetic retinopathy in type 1 and type 2 diabetes mellitus patients in north-east Poland. Materials and Methods: The eye fundus was assessed on the basis of two-field 50 degrees color fundus photographs that showed the optic nerve and macula in the center after the pupil was dilated with 1% tropicamide. Results: The experimental group included 315 (26%) patients with type 1 diabetes mellitus (DM1) and 894 (74%) patients with DM2. DM1 patients were diagnosed with DR in 32.58% of cases, with non-proliferative diabetic retinopathy (NPDR) in 24.44% of cases, proliferative diabetic retinopathy (PDR) in 1.59% of cases, diabetic macular edema (DME) in 5.40% of cases, and PDR with DME in 0.95% of cases. DR was found in DM2 patients in 23.04% of cases, NPDR in 17.11% of cases, PDR in 1.01% of cases, DME in 4.81% of cases, and PDR with DME in 0.11% of cases. Conclusions: The presented study is the first Polish study on the prevalence of diabetic retinopathy presenting a large group of patients, and its results could be extrapolated to the whole country. Diabetic retinopathy was found in 25.48% of patients in the whole experimental group. The above results place Poland within the European average, indicating the quality of diabetic care offered in Poland, based on the number of observed complications.


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