Abstract
Objective: Diabetic retinopathy (DR) is a major cause of vision loss, creating a low quality of life in patients. High blood pressure and serum insulin levels are known to be associated with DR. Though incident diabetic eye disease is reportedly related to systolic blood pressure (SBP), the potential importance of pulse pressure (PP) is not clear. The present study aimed at determining the association between pulse pressure, serum insulin levels and diabetic retinopathy in type 2 diabetes (T2DM) with or without systemic hypertension. Design and Method: Cross-sectional hospital-based study involving type 2 DM female patients with (n = 70) or without systemic hypertension (n = 36). The groups were matched for age, sex and BMI. Anthropometric measurements were taken, fasting blood glucose, glycated hemoglobin, serum insulin, and lipid profile were determined. Results: The mean values for weight and BMI were comparable between the groups, however, DBP, SBP, PP and serum insulin were significantly higher in the hypertensive diabetics. Using multiple regression (stepwise) analysis, there was a strong relationship between PP and DR in hypertensive diabetics (β = 2.239, p < 0.000, R2 = 0.143) while serum insulin showed a strong relationship with DR in patients with only T2DM (β = 2.190, p < 0.000, R2 = 0.253). Receiver operating characteristics (ROC) curve showed that PP with area under the curve (AUC) of 0.746 in hypertensive diabetics and serum insulin with AUC of 0.784 in patients with only T2DM were the most efficient predictors of DR respectively. Conclusions: The findings in the present study indicate that elevated PP and serum insulin could be reliable independent predictors of DR in T2DM female patients with or without systemic hypertension respectively.
Published Version
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