Abstract

Aim. To analyze a clinical case of traction retinal detachment in both eyes in a patient with normal blood glucose levels. To determine additional diagnostic methods for verifying the diagnosis of diabetes mellitus in patients with normal levels of glucose and glycated hemoglobin with diabetic microvascular disorders. Methods. A patient with bilateral retinal traction detachment and without previous diagnosis of diabetes mellitus was observed. The patient had his blood glucose and glycated hemoglobin level within normal laboratory values. Results. A clinical case of a patient with retinal complications of type 2 diabetes mellitus was analyzed and the features of laboratory diagnostics with an initially normal blood glucose level were noted. Conclusions. 1. The level of glycated hemoglobin does not fully reflect the level of glycemic control in diabetes mellitus, unlike indicators such as Time in Range (TIR) and glycemic variability. 2. Decrease of TIR correlates with higher risk of microvascular complications, of progression including diabetic retinopathy. TIR can be calculated with Continuous Glucose Monitoring installed for 14 days, however, due to high cost of equipment, this type of monitoring is not very common. If it is impossible to use special equipment, careful self-monitoring of glycemia up to 6 times a day (before and 2 hours after meals) should be carried out. 3. This clinical case clearly demonstrates that even with a normal level of glycated hemoglobin, development and progression of microvascular complications is possible and confirms the need for more careful self-monitoring of glycemia. Key words: traction retinal detachment; proliferative diabetic retinopathy (PDR).

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