Changes In Diabetic Patients Research Articles

A preliminary study of changes in carotid artery elasticity in type 2 diabetes mellitus.

Carotid stiffening is found to be present in patients with type 2 diabetes mellitus (T2DM) together with endothelial dysfunction and it remains unclear about the role of carotid elasticity in the development of diabetic vascular damage. The aim of the study was to investigate changes and significance of carotid artery elasticity in diabetic patients with or without microvascular complications using velocity vector imaging (VVI) analysis. Fifty participants were enrolled and divided into health Control group, the uncomplicated DM (uDM) group and the complicated DM (cDM) group. All of them underwent carotid ultrasound examinations. VVI was used to evaluate the common carotid artery (CCA) elasticity and intima-media thickness (IMT) was also measured. Flow-mediated dilation (FMD) was performed to detect the vascular endothelial function. Then differences and correlations of variables between three groups were compared and analyzed. CCA elasticity measured by VVI decreased significantly between three groups (p < 0.05), while FMD decreased significantly only in cDM group (p < 0.01) and only IMT in cDM group was significantly thicker than that of Control group (p < 0.05). Representative VVI variables were independently, negatively related to the known duration and microalbuminuria (p < 0.05). All VVI variables were significantly correlated with FMD (0.5 ≤ |r | <0.8, p < 0.001), and just a small part of VVI variables were significantly correlated with IMT (0.3 ≤ |r | <0.5, p < 0.05). Compared with FMD, CCA elasticity measured by VVI showed more obvious changes in diabetic patients with different levels of vascular damage and may be considered as an alternative indicator in evaluating arterial status of T2DM.

Proinflammatory Cytokines Trigger the Onset of Retinal Abnormalities and Metabolic Dysregulation in a Hyperglycemic Mouse Model.

Recent evidence has shown that retinal inflammation is a key player in diabetic retinopathy (DR) pathogenesis. To further understand and validate the metabolic biomarkers of DR, we investigated the effect of intravitreal proinflammatory cytokines on the retinal structure, function, and metabolism in an in vivo hyperglycemic mouse model. C57Bl/6 mice were rendered hyperglycemic within one week of administration of a single high-dose intraperitoneal injection of streptozotocin, while control mice received vehicle injection. After confirming hyperglycemia, the mice received an intravitreal injection of either proinflammatory cytokines (TNF-α and IL-1β) or vehicle. Similarly, control mice received an intravitreal injection of either proinflammatory cytokines or vehicle. The retinal structure was evaluated using fundus imaging and optical coherence tomography, and retinal function was assessed using a focal electroretinogram (ERG), two days after cytokine injection. Retinas were collected for biochemical analysis to determine key metabolite levels and enzymatic activities. Hyperglycemic mice intraocularly injected with cytokines developed visible retinal vascular damage and intravitreal and intraretinal hyper-reflective spots two days after the cytokines injection. These mice also developed a significant functional deficit with reduced a-wave and b-wave amplitudes of the ERG at high light intensities compared to control mice. Furthermore, metabolic disruption was evident in these mice, with significantly higher retinal glucose, lactate, ATP, and glutamine levels and a significant reduction in glutamate levels compared with control mice. Minimal or no metabolic changes were observed in hyperglycemic mice without intraocular cytokines or in control mice with intraocular cytokines at 2 days post hyperglycemia. Proinflammatory cytokines accelerated the development of vascular damage in the eyes of hyperglycemic mice. Significant changes were observed in retinal structure, function, and metabolic homeostasis. These findings support the idea that with the onset of inflammation in DR, there is a deficit in metabolism. Therefore, early intervention to prevent inflammation-induced retinal changes in diabetic patients may improve the disease outcome.

Role of distal motor latency (M), F-wave latency (F), and M/F ratio in type-II diabetes mellitus

Background: Diabetic neuropathy is a common complication of diabetes mellitus and early diagnosis is crucial to prevent its progression. Aims and Objective: This study aimed to assess the distal motor latency (DML), F-wave latency, and M/F ratio in type-II diabetic patients. Materials and Methods: It was a cross-sectional study with comparison group conducted in the department of neurology in collaboration with the department of physiology in a tertiary care hospital. A total of 120 diagnosed patients were enrolled in this study. A thorough clinical evaluation, including neurological examinations, assessment of neuropathic symptoms, and relevant biochemical tests, were done in all participants. Nerve conduction studies were performed to measure DML and F-wave latency, whereas the M/F ratio was calculated for each participant. Results: Based on the findings, 66 patients had no signs or symptoms of neuropathy and were considered the control group whereas 54 patients having signs and symptoms of neuropathy were considered cases. The results were compared in both the groups (diabetic patients without neuropathy as control and diabetic patients with neuropathy as cases). The results of this study showed significantly prolonged DML and F-wave latency in diabetic patients with neuropathy (cases) as compared to the control group (P &lt; 0.05). In addition, the M/F ratio was significantly lower in diabetic patients with neuropathy compared to controls (P &lt; 0.05). Conclusion: These non-invasive nerve conduction parameters can aid in the early detection of neuropathic changes in diabetic patients, allowing for timely intervention and improved management of the condition.

Diabetic cardiomyopathy: Clinical phenotype and practice.

Diabetic cardiomyopathy (DCM) is a pathophysiological condition of cardiac structure and function changes in diabetic patients without coronary artery disease, hypertension, and other types of heart diseases. DCM is not uncommon in people with diabetes, which increases the risk of heart failure. However, the treatment is scarce, and the prognosis is poor. Since 1972, one clinical study after another on DCM has been conducted. However, the complex phenotype of DCM still has not been fully revealed. This dilemma hinders the pace of understanding the essence of DCM and makes it difficult to carry out penetrating clinical or basic research. This review summarizes the literature on DCM over the last 40 years and discusses the overall perspective of DCM, phase of progression, potential clinical indicators, diagnostic and screening criteria, and related randomized controlled trials to understand DCM better.

Characterizing conventional ankle MRI findings of nerve and muscle changes in diabetic patients: a case-control study.

Foot and ankle amputation is a feared complication of diabetic neuropathy and diabetes mellitus (DM) accounts for 80% of all in-hospital amputations. Magnetic resonance neurography is an effective tool in characterizing neuromuscular sequelae of the disease. However, conventional ankle MRI is more commonly performed and has not been studied to assess neuromuscular changes of DM. The objective is to characterize neuromuscular changes of diabetic patients in a case-control study using conventional ankle MRI. Between November 2019 and July 2021, 110 consecutive ankle MRI scans (n = 102 patients) at our county hospital were reviewed and met the inclusion criteria. Patients were divided into two cohorts, diabetic (N = 63) and non-diabetic (N = 39). Demographics, HgbA1c, and reason for MRI study were collected via retrospective chart review. The presence of intramuscular edema-like signal, pattern of the edema, muscle fatty infiltration, and measurements of the cross-sectional area of the posterior, medial, and lateral tibial nerves (PTN, MPN, and LPN) was recorded blinded to the clinical findings by two readers. Muscle edema-like signal was much more likely to be found in DM (odds ratio 19.5, 95% CI 7.0-54.6, p < 0.001). DM also showed increase of 0.87 in the mean grade of muscle fatty infiltration (p < 0.001). There were higher rates of nerve T2 hyperintensity (odds ratio 14.0, 95% CI 3.1-62.7, p < 0.001) and the measured areas of the PTN, MPN, and LPN were also larger in DM compared to their non-diabetic counterparts (PTN: 0.16 cm2 vs. 0.10 cm2, p < 0.01; MPN: 0.09 cm2 vs. 0.05 cm2, p < 0.01; LPN: 0.07 cm2 vs. 0.04 cm2, p < 0.05). Conventional ankle MRIs can be used to detect DM-related neuromuscular changes.

Risk of acute angle-closure and changes in intraocular pressure after pupillary dilation in patients with diabetes.

To evaluate the risk of AAC and intraocular pressure (IOP) changes in diabetic patients after pupil dilation. This cross-sectional study enrolled 2,287 diabetic patients among community residents in Guangzhou, China. All participants underwent routine pupil dilation unless they had a history of glaucoma. IOP was measured using a non-contact tonometer before and one hour after pupil dilation with tropicamide 0.5% and phenylephrine 0.5% eye drop. The proportion of AAC and changes in IOP after pupil dilation were evaluated. Only one of the 2,287 participants (0.04%) with diabetes developed post-dilation AAC. The mean pre and post-dilation IOP in the right was 16.1 ± 2.7 and 16.5 ± 2.8 mmHg (P < 0.001); mean pre and post-dilation IOP in the left was 16.5 ± 2.7 and 16.8 ± 2.8 mmHg (P < 0.001). Sixty-one participants (2.7%) showed an increase in IOP ≥ 5 mmHg and 25 participants (1.1%) showed a post-dilation IOP > 25 mmHg, including 11 participants (0.5%) who had both an increase in IOP ≥ 5 mmHg and post-dilation IOP > 25 mmHg. Lower pre-dilation IOP (OR = 0.827; 95% CI, 0.742-0.922; P = 0.001) and shallower anterior chamber depth (ACD) (OR = 0.226; 95% CI, 0.088-0.585; P = 0.002) were significant risk factors for an increase in IOP ≥ 5 mmHg in multivariate logistic regression analysis. The risk of developing AAC after pupil dilation in diabetic patients was very low. Lower pre-dilation IOP and shallower ACD are risk factors for increased post-dilation IOP.

QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY REVEALS ROD PHOTORECEPTOR DEGENERATION in EARLY DIABETIC RETINOPATHY.

This study is to test the feasibility of optical coherence tomography (OCT) detection of photoreceptor abnormality and to verify that the photoreceptor abnormality is rod predominated in early diabetic retinopathy (DR). OCT images were acquired from normal eyes, diabetic eyes with no DR, and mild nonproliferative DR (NPDR). Quantitative features, including thickness measurements quantifying band distances and reflectance intensity features among the external limiting membrane, inner segment ellipsoid, interdigitation zone, and retinal pigment epithelium were determined. Comparative OCT analysis of central fovea, parafovea, and perifovea were implemented to verify that the photoreceptor abnormality is rod predominated in early DR. Thickness abnormalities between the inner segment ellipsoid and interdigitation zone also showed a decreasing trend among cohorts. Reflectance abnormalities of the external limiting membrane, interdigitation zone, and inner segment ellipsoid were observed between healthy, no DR, and mild NPDR eyes. The normalized inner segment ellipsoid/retinal pigment epithelium intensity ratio revealed a significant decreasing trend in the perifovea, but no detectable difference in central fovea. Quantitative OCT analysis consistently revealed outer retina, i.e., photoreceptor changes in diabetic patients with no DR and mild NPDR. Comparative analysis of central fovea, parafovea, and perifovea confirmed that the photoreceptor abnormality is rod-predominated in early DR.

The Longitudinal Assessment of Vascular Parameters of the Retina and Their Correlations with Systemic Characteristics in Type 2 Diabetes-A Pilot Study.

The aim of the study was to assess various retinal vessel parameters of diabetes mellitus (DM) patients and their correlations with systemic factors in type 2 DM. A retrospective exploratory study in which 21 pairs of baseline and follow-up images of patients affected by DM were randomly chosen from the Sankara Nethralaya–Diabetic Retinopathy Study (SN DREAMS) I and II datasets. Patients’ fundus was photographed, and the diagnosis was made based on Klein classification. Vessel thickness parameters were generated using a web-based retinal vascular analysis platform called VASP. The thickness changes between the baseline and follow-up images were computed and normalized with the actual thicknesses of baseline images. The majority of parameters showed 10~20% changes over time. Vessel width in zone C for the second vein was significantly reduced from baseline to follow-up, which showed positive correlations with systolic blood pressure and serum high-density lipoproteins. Fractal dimension for all vessels in zones B and C and fractal dimension for vein in zones A, B and C showed a minimal increase from baseline to follow-up, which had a linear relationship with diastolic pressure, mean arterial pressure, serum triglycerides (p < 0.05). Lacunarity for all vessels and veins in zones A, B and C showed a minimal decrease from baseline to follow-up which had a negative correlation with pulse pressure and positive correlation with serum triglycerides (p < 0.05). The vessel widths for the first and second arteries significantly increased from baseline to follow-up and had an association with high-density lipoproteins, glycated haemoglobin A1C, serum low-density lipoproteins and total serum cholesterol. The central reflex intensity ratio for the second artery was significantly decreased from baseline to follow-up, and positive correlations were noted with serum triglyceride, serum low-density lipoproteins and total serum cholesterol. The coefficients for branches in zones B and C artery and the junctional exponent deviation for the artery in zone A decreased from baseline to follow-up showed positive correlations with serum triglycerides, serum low-density lipoproteins and total serum cholesterol. Identifying early microvascular changes in diabetic patients will allow for earlier intervention, improve visual outcomes and prevent vision loss.

Structural and functional retinal changes in patients with type 2 diabetes without diabetic retinopathy

Objective The characteristics of the early changes in preclinical diabetic retinopathy (DR) are poorly known. This study aimed to analyse the changes in the structure and function of the fundus in diabetic patients without diabetic retinopathy (NDR). Methods This prospective study enrolled patients with type 2 diabetes and healthy controls from April to December 2020. Retinal sensitivity was measured by microperimetry. The peripapillary retinal nerve fibre layer (p-RNFL) thickness, macular retinal thickness, and retinal volume were measured by optical coherence tomography (OCT). The vessel density (VD) and perfusion density (PD) of the peripapillary area, as well as the foveal avascular zone (FAZ) area, FAZ perimeter, and FAZ circularity, were measured by optical coherence tomographic angiography (OCTA). Results A total of 71 cases (100 eyes) were enrolled in the study, including 34 cases (51 eyes) in the NDR group and 37 cases (49 eyes) in the control group. The mean retinal sensitivity was lower in the NDR group than in the control group for all sectors (all p < .001). Compared with controls, the NDR group showed thinner p-RNFL in the T sector (76.24 ± 14.29 vs. 85.47 ± 19.66 µm, p = .035). The NDR group had a thinner retina in the N2 sector (304.55 ± 16.07 vs. 312.02 ± 12.30 µm, p = .010). The PD of DCP was lower in the N2 sector in the NDR group (44.92 ± 11.77 vs. 50.27 ± 6.37%, p = .044). The VD was higher in the NDR group in RPCP-S/N/I, and the PD was higher in the RPCP-S/N (all p < .05). The frequencies of perifoveal capillary drop-out, notched or punched out borders of the superficial FAZ, and loss of smooth contour were all higher in the NDR group (all p < .05). Conclusion The structure (p-RNFL thickness, VD, and PD) and function (retinal sensitivity) display some changes in diabetic patients even if they had not been found to have DR. Key messages Decreased retinal sensitivity was observed in diabetic patients before the onset of diabetic retinopathy. Compared with the control group, we found the changes in vessel density or perfusion density in a certain area, whether in SCP, DCP, or RPCP in the NDR group. Before the onset of diabetic retinopathy, the structure and function of the retina in diabetic patients had changed.

Relationship Between Risk Factors and Macular Thickness in Patients with Early Diabetic Retinopathy.

PurposeThe purpose of this study was to explore the changes in macular thickness (MT) in normal people, patients without obvious diabetic retinopathy (NDR) and patients with nonproliferative diabetic retinopathy (NPDR) and to study the possible risk factors for early diabetic retinopathy (DR).MethodsThirty-one healthy individuals, 40 people with no sign of DR and 60 people with mild NPDR were included in this cross-sectional study. All patients underwent a complete ophthalmological examination. Optical coherence tomography (OCT) was used to measure the MT of each participant. The potential relationship between MT and systemic risk factors for DR, including diabetes duration, body mass index (BMI), hemoglobin A1c (HbA1c), serum lipids, and blood pressure, was analyzed.ResultsThe MT of the right and left eyes in the central and inner ring regions of the NPDR group and NDR group were significantly different from that in the control group. The MTs of the right and left eyes in the central region and inner ring region were also significantly different between the NPDR group and NDR group, but the MTs of the right and left eyes in the outer ring region were not significantly different among the three groups. Diabetic duration, total cholesterol (TC), triglycerides (TGs), systolic pressure, and diastolic pressure were positively correlated with the MT of the right and left eyes in the central region.ConclusionMT increases, especially in the central region and inner ring, may be the first structural retinal change in diabetic patients and is related to the duration of diabetes, TC, TG, systolic pressure and diastolic pressure.

Correlation between HbA1c and carotid artery intima-media thickening(cIMT) in diabetic patients

Introduction: Correlation between carotid artery intima-media thickening and HbA1c levels in diabetic patients as a non invasive marker of progressive atherosclerosis. Objectives: The aim of this study is to study the role of two non invasive markers, carotid intima media thickening and HbA1c in diabetic patients and establish the usefulness of both the parameters in evaluating early risk factor assessment. Material and methods: 100 patients meeting the required criteria were taken coming to OPD/IPD bases to Dhiraj hospital in the age group of 35-70 years.HbA1c levels were used according to American diabetes association. Carotid intima media thickening was measures on B mode ultrasonography in radiology department. Results: among the 100 patients, 68 patients were female and 32 patients were male. The mean of HbA1c values were 8.0 ± 2.2%. The mean cIMT values were 0.78 ± 0.3 cm. Conclusion: HbA1c and carotid artery intimal thickness is useful as a diagnostic marker and early risk factor analysis for atherosclerotic changes in diabetic patients.

Biochemical cardiac markers

Aim: The aim of this study is to estimate the changes in cardiac markers in type 2 diabetic patients with and without cardiovascular changes. Methods: In this cross -sectional study, 240 patients with diabetes mellitus type 2 were recruited. The biochemical marker of each patient is compared . Blood samples were gathered and processed for the estimation of CK-MB, LDH, trop-t ,uric acid, microalbuminuria and HbA1c. Results: Diabetic individuals had high levels CK-MB, LDH, trop-t and uric acid as compared with and without (CVS)cardiovascular changes in diabetic patients.. Study suggested that cardiac marker levels were significantly increased in hypertensive patients who’s suffering from diabetes mellitus. Conclusion: There is a need for periodic assessment of the cardiac function and biochemical markers in diabetic patients so that patients can take early preventative measures. Early assessment of the cardiac function and biochemical markers provides early warning signals for patients to take additional precautions.

In vitro Study of Antioxidant, Anti-Diabetic and Anti- Atherosclerotic Activity of Cold and Hot Leaf Extracts from Trigonella foenum gracecum. L

Background: Diabetes mellitus, a heterogeneous metabolic disease characterized by altered carbohydrate, protein and lipid metabolism. Increased glucose level has a causal correlation with atherosclerotic changes in diabetic patients. Regulating blood glucose may prevent diabetes-related tissue damage and secondary complications associated.&#x0D; Methods: In the present study, an attempt has been made to investigate the Anti-diabetic and Anti-atherosclerotic effect exhibited by Cold and Hot extracts of Trigonella foenum leaves samples.&#x0D; Results: It was deduced that the Cold extracts of fenugreek leaves had more of Phenolic compounds, while the Hot extracts had Increased amount of Carbohydrates. In the Anti Atherosclerotic studies, it was observed that the Cold extract (34%) possessed higher Cardioprotective activity than the Hot extract (14%) of T. foenum leaves when compared with the Ascorbic acid (80%) as Standard. Increased glucose level has a causal correlation with atherosclerotic changes in diabetic patients. The Antidiabetic studies of both the extracts Hot and Cold of T. foenum leaves were studied. In the Alpha- amylase inhibition assay, it was seen that both the Cold (70.1±3.5) and Hot extract (69.1±2.5) of T. foenum leaves showed significant results when compared with the Standard Acorbase (72.5±2.0). Similarly, in Glucose diffusion inhibition assay, it was seen that both the Cold (48.54%) and Hot extract (47.51%) of T. foenum leaves, when compared with the standard Metformin (70.84%) showed potent Anti-Diabetic activity.&#x0D; Conclusion: From the above results, it can be concluded that T. foenum leaves in both Hot and Cold treated, possesses antioxidant activity, anti-atherosclerotic, anti-diabetic activity.

Choroidal structural alterations in diabetic patients in association with disease duration, HbA1c level, and presence of retinopathy.

To assess choroidal structural changes in diabetic patients in association with disease duration, HbA1c level, and presence of retinopathy. This retrospective cross-sectional study included treatment-naive patients with non-proliferative DR (NPDR) (group 1), diabetic patients without DR (group 2), and healthy subjects (group 3). Patients were also grouped according to the duration of diabetes: long-term group (> 15years, n = 32) and short-term group (˂ 15years, n = 28). The choroidal thickness was measured at three points; subfoveal, 1500μm nasal, and 1500μm temporal to the fovea. The choroidal area, stromal area, luminal area (LA), and choroidal vascularity index (CVI) were quantified using ImageJ. Partial correlation analysis and one-way analysis of covariance test were performed for statistical analysis. The study included 30 eyes of 30 treatment-naive patients with NPDR (group 1), 30 eyes of 30 diabetic patients without DR (group 2), and 30 eyes of 30 healthy persons (group 3). The mean subfoveal, nasal, and temporal choroidal thicknesses were decreased in group 1 in comparison with controls (p < 0.001, p = 0.035, and p = 0.005, respectively). The mean LA in group 1 and group 2 were both significantly lower compared to group 3 (group 1 vs. group 3, p = 0.004; group 2 vs. group 3, p = 0.020). CVI was significantly lower in group 1 and group 2 than in controls (group 1 vs. group 3, p = 0.019; group 2 vs. group 3, p = 0.025). CVI was significantly lower in the long-duration group than in the short-duration group (p < 0.001). A moderate negative correlation was found between the duration of diabetes and CVI (r = - 0.467, p < 0.001). A moderate negative correlation was found between HbA1c level and luminal area and CVI (r = - 0.466, p < 0.001, and r = - 0.425, p < 0.001, respectively). Choroidal structure and CVI are altered even in the absence of clinically confirmed retinopathy and these alterations are related to the duration of diabetes.

Study of proliferative diabetic retinopathy and its correlation with hypertension, dyslipidaemia and diabetic nephropathy

Background: Diabetes Mellitus (DM) is a commonly encountered micro vascular disorder in ophthalmic outpatient department. It is estimated that approximately 191 million people may be suffering from this disorder by year 2030. (3) The rapid increase in number of persons with Diabetes is expected to lead to an increase in number of persons with ocular complications of diabetes. The prevalence of retinopathy changes in diabetic patients varies considerably, but is probably 20 to 30 % and out of it, 3-4% cases are of proliferative diabetic retinopathy.(4) Diabetic Retinopathy has been studied extensively in past about its effect on vision, different pathologies, incidence, prevalence, risk factors, its various diagnostic techniques and treatment modalities.(5-9) However the correlation of proliferative diabetic retinopathy with hypertension, dyslipidaemia and diabetic nephropathy and its prognosis has not been studied adequately which warrants further studies. These risk factors once accurately identified and appropriately controlled at an early stage, progression of diabetic retinopathy and its subsequent effect on vision can be effectively controlled. Aims and objectives: To study the clinical profile, presentation of proliferative diabetic retinopathy in type 2 diabetic patients and its correlation with hypertension, dyslipidaemia and diabetic nephropathy.

Relationship between glycosylated hemoglobin and vitamin B12 deficiency anemia.

Previous studies showed that vitamin B12 deficiency anemia causes a false increase in glycosylated hemoglobin (HbA1c) and that HbA1c decreases with B12 treatment. However, no study has been conducted on how much an increase in hemoglobin (Hgb) level causes a decrease in HbA1c level after treatment. The study included 37 patients who were not diagnosed with diabetes, did not use anti-diabetic drugs, were pre-diabetic according to HbA1c level, and were diagnosed with vitamin B12 deficiency anemia in the patient group and 40 healthy volunteers of similar age and gender characteristics in the control group. The patient group was given 1 mg/day of cyanocobalamin (vitamin B12) orally for 3 months. Patients' Hgb, mean corpuscular volume, fasting plasma glucose, HbA1c, and vitamin B12 values were compared at the beginning and at the end of the 3rd month. In the patient group, it was determined that 0.94 mg/dL increase in Hgb after vitamin B12 treatment caused a 0.24 decrease in HbA1c (%). The initial HbA1c of the patient group was 6.01±0.20 and the 3rd-month HbA1c was 5.77±0.33; the initial and 3rd-month Hgb values were 11.31±0.28 and 12.26±0.33, respectively; the initial and 3rd-month vitamin B12 (ng/L) levels were 112.43±7.18 and 408.48±119.61, respectively; and there was a significant difference between the initial and 3rd-month values (p<0.001, p<0.001, p<0.001, respectively). Moreover, 35% of the patients in the patient group had no diagnosis of prediabetes according to the HbA1c level at the end of the 3rd month. Elimination of vitamin B12 deficiency anemia before making a diagnosis or treatment decision according to HbA1c level will prevent patients from misdiagnosis of diabetes and unnecessary treatment changes in diabetic patients.

Ability of Short wavelength automated perimetry to detect visual field changes in diabetic patients

Ability of Short wavelength automated perimetry to detect visual field changes in diabetic patients

The Corneal Changes in Diabetic Patients

Abstract Diabetes mellitus (DM) represents a systemic disorder which afects different organs. Ocular complications of the DM are the worldwide leading cause of blindness. The most common complications are diabetic retinopathy, diabetic cataract, neovascular glaucoma. Recently many investigations point out that DM can cause comlications at ocular surface as well. Condition such as decreased corneal sensitivity, dry eye or neurotrophic corneal ulceraction are the main clinical manifestations of the diabetic keratopathy (DK). Untreated, these conditions can lead to serious visual acuity decrease. Pathological processes, based on chronic inflammation, due to chronic hyperglycemia, are the main step in the process of DK development. Adequate treatment of the main disease - DM is an imperative in maintaining the healthy cornea without subjective sensations of diabetic patients.

Imaging evaluation of the pancreas in diabetic patients.

Diabetes mellitus (DM) is becoming a global epidemic and its diagnosis and monitoring are based on laboratory testing which sometimes have limitations. The pancreas plays a key role in metabolism and is involved in the pathogenesis of DM. It has long been known through cadaver biopsies that pancreas volume is decreased in patients with DM. With the development of different imaging modalities over the last two decades, many studies have attempted to determine whether there other changes occurred in the pancreas of diabetic patients. This review summarizes current knowledge about the use of different imaging approaches (such as CT, MR, and US) and radiomics for exploring pancreatic changes in diabetic patients. Imaging studies are expected to produce reliable information regarding DM, and radiomics could provide increasingly valuable information to identify some undetectable features and help diagnose and predict the occurrence of diabetes through pancreas imaging.

Retinal Microvascular Changes in Diabetic Patients: OCTA Findings*

Retinal Microvascular Changes in Diabetic Patients: OCTA Findings*