Clinical Evaluation of Correlation Between Diabetic Retinopathy with Modifiable, Non-Modifiable and Other Independent Risk Factors in Tertiary Set-up in Central Rural India

AIM: To assess the effect of age at diabetes onset and uncontrollable high HbA1c levels on the development of diabetic retinopathy (DR) among Chinese type 2 diabetes mellitus (DM) patients. METHODS: This was a cross-sectional survey of diabetic patients in Subei district, China. Data covering physical measurements, fasting blood-glucose (FBG), glycosylated hemoglobin (HbA1c), blood lipid, urinary albumin/creatinine ratio (UACR), ocular fundus examination, and diabetes treatment records were collected. An independent sample t-test were used to analyze differences. A Logistic regression analysis was applied to study the independent risk factors of DR. RESULTS: A total of 1282 patients with type 2 DM were enrolled, and 191 cases had DR (14.9%). The age at diabetes onset, education level, alcohol consumption, HbA1c level, UACR level, and hypoglycemic drugs were independent influencing factors for DR. The older the onset of diabetes, the less likely to develop DR (OR: 0.958, 95%CI: 0.942-0.975, P=0.000). Patients were then divided in terms of age at diabetes onset as follows: <50y, 50-59y, 60-69y, and ≥70y. Compared with diabetes onset age <50y, 50-59y (OR: 0.463, 95%CI: 0.306-0.699, P=0.000), 60-69y (OR: 0.329, 95%CI: 0.203-0.535, P=0.000) and ≥70y (OR: 0.232, 95%CI: 0.094-0.577, P=0.002) were at a lower risk of DR. The prevalence of DR was highest in patients with diabetes onset age <50y (29.5%, P<0.05). The HbA1c level (8.67±1.97)% and proportion of insulin injection (52.5%) in patients with diabetes onset <40y were higher than in patients with older diabetes onset age (P<0.05). CONCLUSION: Diabetes onset at an earlier age and uncontrollable high HbA1c level could be independent risk factors for DR.

Download Full-text

Prevalence and risk factors for diabetic retinopathy in rural India. Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study III (SN-DREAMS III), report no 2

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2013-000005 ◽

2014 ◽

Vol 2 (1) ◽

pp. e000005 ◽

Cited By ~ 44

Author(s):

Rajiv Raman ◽

Suganeswari Ganesan ◽

Swakshyar Saumya Pal ◽

Vaitheeswaran Kulothungan ◽

Tarun Sharma

Keyword(s):

Risk Factors ◽

Diabetic Retinopathy ◽

Genetic Study ◽

Molecular Genetic ◽

Rural India ◽

Molecular Genetic Study

Download Full-text

Low prevalence of diabetic retinopathy in patients with long-term type 1 diabetes and current good glycemic control - one-center retrospective assessment

Endocrine ◽

10.1007/s12020-021-02871-2 ◽

2021 ◽

Author(s):

Paulina Surowiec ◽

Bartłomiej Matejko ◽

Marianna Kopka ◽

Agnieszka Filemonowicz-Skoczek ◽

Tomasz Klupa ◽

...

Keyword(s):

Risk Factors ◽

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Glycemic Control ◽

De Novo ◽

University Hospital ◽

Specialist Care ◽

Good Glycemic Control ◽

Independent Risk Factors

Abstract Purpose Despite progress in type 1 diabetes (T1DM) therapy, diabetic retinopathy (DR) is still a common complication. We analysed predictors and prevalence of DR in patients with T1DM lasting 10 years or more. All of the patients were considered to be currently in excellent glycemic control and treated using modern therapies. Methods Study included 384 (80.7% women) T1DM patients participating in the Program of Comprehensive Outpatient Specialist Care at the University Hospital in Krakow between the years 2014 and 2020. A retrospective analysis of medical records was conducted. Results The patients were on average 34 ± 9.2 years old, had a BMI 25.0 ± 3.9 and a T1DM duration of 20.5 ± 7.9 years. The mean level of HbA1c throughout the follow-up (mean duration 4.9 ± 1.4 years) was 6.9 ± 1%. The group included 238 (62.0%) patients treated with insulin pumps and 99 (25.8%) on multiple daily injections, 47 (12.2%) used both methods; almost all patients were on insulin analogues. DR was confirmed in 150 (39.1%) patients, from which 109 (28.4%) were diagnosed de novo. Severe DR was occurred in just 31 cases (8.1%). In the multivariate logistic regression, independent risk factors for the presence of DR were T1DM duration (OR 1.13; 95% CI, 1.09–1.19), HbA1c level (OR 1.41; 95% CI, 1.08–1.84), LDL level (OR 1.79; 95% CI, 1.16–2.87), and the combined presence of non-DR micro- and macrovascular chronic complications (OR 1.86; 95% CI, 1.16–3.03). Conclusions In this highly-selected group of T1DM patients, mostly female, the prevalence of both DR at any stage and severe DR was lower than earlier reported results from other cohorts. Independent risk factors for the DR cohort did not differ from previously reported studies.

Download Full-text

Risk factors for diabetic retinopathy in rural India

Journal of Postgraduate Medicine ◽

10.4103/0022-3859.52837 ◽

2009 ◽

Vol 55 (2) ◽

pp. 89 ◽

Cited By ~ 1

Author(s):

V Mohan ◽

R Pradeepa

Keyword(s):

Risk Factors ◽

Diabetic Retinopathy ◽

Rural India

Download Full-text

Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical Study

Canadian Respiratory Journal ◽

10.1155/2020/1324348 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Qimin Chen ◽

Ming Liu ◽

Bo Liu ◽

Wei Li ◽

Daixiu Gao ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Logistic Regression ◽

Intensive Care ◽

Respiratory Failure ◽

Clinical Study ◽

Predictive Model ◽

Retrospective Clinical Study ◽

Independent Risk Factors ◽

Set Up

Background. Noninvasive ventilation (NIV) has been reported to be beneficial for patients with acute respiratory failure in intensive care unit (ICU); however, factors that influence the clinical outcome of NIV were unclarified. We aim to determine the factors that predict the failure of NIV in critically ill patients with acute respiratory failure (ARF). Setting. Adult mixed ICU in a medical university affiliated hospital. Patients and Methods. A retrospective clinical study using data from critical adult patients with initial NIV admitted to ICU in the period August 2016 to November 2017. Failure of NIV was regarded as patients needing invasive ventilation. Logistic regression was employed to determine the risk factor(s) for NIV, and a predictive model for NIV outcome was set up using risk factors. Results. Of 101 included patients, 50 were unsuccessful. Although more than 20 variables were associated with NIV failure, multivariate logistic regression demonstrated that only ideal body weight (IBW) (OR 1.110 (95%1.027–1.201), P=0.009), the maximal heart rate during NIV period (HR-MAX) (OR 1.024 (1.004–1.046), P=0.021), the minimal respiratory rate during NIV period (RR-MIN) (OR 1.198(1.051–1.365), P=0.007), and the highest body temperature during NIV period (T-MAX) (OR 1.838(1.038–3.252), P=0.037) were independent risk factors for NIV failure. We set up a predictive model based on these independent risk factors, whose area under the receiver operating characteristic curve (AUROC) was 0.783 (95% CI: 0.676–0.899, P<0.001), and the sensitivity and specificity of model were 68.75% and 71.43%, respectively, with the optimal cut-off value of 0.4863. Conclusion. IBW, HR-MAX, RR-MIN, and T-MAX were associated with NIV failure in patients with ARF. A predictive model based on the risk factors could help to discriminate patients who are vulnerable to NIV failure.

Download Full-text

Identification of independent risk factors for the development of diabetic retinopathy requiring treatment

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2009.01742.x ◽

2009 ◽

Vol 89 (6) ◽

pp. 515-521 ◽

Cited By ~ 29

Author(s):

Jesper Mehlsen ◽

Mogens Erlandsen ◽

Per L. Poulsen ◽

Toke Bek

Keyword(s):

Risk Factors ◽

Diabetic Retinopathy ◽

Independent Risk Factors

Download Full-text

Risk factors of diabetic retinopathy and sight-threatening diabetic retinopathy: a cross-sectional study of 13 473 patients with type 2 diabetes mellitus in mainland China

BMJ Open ◽

10.1136/bmjopen-2017-016280 ◽

2017 ◽

Vol 7 (9) ◽

pp. e016280 ◽

Cited By ~ 24

Author(s):

Yan Liu ◽

Jiarui Yang ◽

Liyuan Tao ◽

Huibin Lv ◽

Xiaodan Jiang ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Diabetic Retinopathy ◽

Blood Glucose ◽

Mainland China ◽

Diabetes Duration ◽

Postprandial Blood Glucose ◽

Cross Sectional ◽

Younger Age ◽

Independent Risk Factors

ObjectiveTo explore the risk factors of diabetic retinopathy (DR) and sight-threatening diabetic retinopathy (STDR) among Chinese patients with diabetes.Design, setting and participantsA cross-sectional investigation was performed in eight screening clinics in six provinces across mainland China. Information about the risk factors was recorded in screening clinics. Some risk factors (sex, age, diagnosis age, diabetes duration, systolic blood pressure (SBP), diastolic blood pressure, fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c)) were recorded in all eight clinics, while others were collected only in a subset of the clinics. The relationships between the risk factors and DR and between the risk factors and STDR were explored for the eight factors mentioned above and for all factors studied.Main outcomes and measuresRisk factors of DR and STDR were assessed, and a nomogram of the results was produced.ResultsYounger age, longer diabetes duration, higher SBP, higher FBG and higher HbA1c were found to be independent risk factors for both DR and STDR in the eight-factor analyses. In the all-factor analysis, younger age, longer diabetes duration, higher SBP, oral medicine use and insulin use were independent risk factors for both DR and STDR; higher postprandial blood glucose (PBG), HbA1c, triglyceride andlow-density lipoprotein were independent risk factors for DR only, and higher FBG was a risk factor for STDR only.ConclusionsIn this cross-sectional investigation, several risk factors were found for DR and STDR. Notably, FBG, PBG and HbA1c were all risk factors for DR or STDR, suggesting that stricter blood glucose control in clinical practice is required.

Download Full-text