A study of diabetic retinopathy in type 2 diabetic patients and its relation with diabetic progression

Abstract

The study aimed to investigate the diabetic retinopathy in type 2 diabetic patients and its relation with the glycemic control represented with the glycatedhaemoglobin (HbA1c). The study performed in the diabetic and endocrinology center at Al-Sader medical city in Al-Najaf Al-Ashraf. The study included 102 subjects, divided into a (10) healthy subjects ascontrol group and two groups of diabetic patients attended to the diabetic and endocrinology center at Al-Sader medical city and diagnosed as type 2 diabetic patients, divided into two groups with and without retinopathy. The type of retinopathy was determined by physicians, there are three retinopathy subtypes: diabetic retinopathy in early stages, proliferative retinopathy and macular edema.Most DR patients were in early stages of retinopathy 37.25%, proliferative diabetic retinopathy 11.76%, and macular edema 11.76%.The results shows a significant increase of diabetic retinopathy DR prevalence with increasing diabetic duration, the incidence of DR was highest in patients of 15-20 years of diabetes mellitus,and the highest were the proliferative , then macular edema 12.33 ± 18.6 and 14.16 ± 2.32 respectively. The level of fasting plasma glucose among control, DM and DR groups increased significantly (P < 0.05), while there was no significant differences (P < 0.05) in FPG levels between these subtypes of DR. The HbA1c was significantly highest (P<0.05 )in DM and DR (6.65% ± 0.29 and 8.025 ± 0.19 respectively) when compared with 5.73% ± 0.18 in the control group. According to the successive HbA1c percentiles,the early stages of DR were found in all levels of HbA1c, but the highest incidence were in the highest levels. Also proliferative DR begin to appear at 7-7.5 % of HbA1c, andits highest incidence were at 7.5 – 8 %. Macular edema increased at 7-7.5% and at levels highest than 10.5 %.There was a significant decrease in body mass index BMI in DR patients when compared with other groups, and a significant decrease in BMI in proliferative DR and macular edema when compared with the control.The study concluded that there is a critical need to perform a periodical check to diabetic patients to diagnose the retinopathy in its early appearance, and to use the glycosylated haemoglobin as measurement periodically to detect any increase or fluctuation in this parameter to control the glycemic state in these patients.