Prevalence Of Retinopathy Research Articles

Residential greenness exposure and decreased prevalence of diabetic retinopathy: A nationwide analysis in China

ObjectiveDiabetic retinopathy (DR) is a leading cause of vision impairment and blindness among diabetics. We aimed to explore whether long-term exposure to residential greenness was beneficial to DR. Research design and methodsWe used data from a large-scale, cross-sectional screening survey conducted in 129 cities of 27 provincial regions of China from 2018 to 2021 among patients with diabetes. We measured residential greenness exposure as the 3-year average of annual maximum Normalized Difference Vegetation Index (NDVI) at a spatial resolution of 250 m. DR was assessed by ophthalmologists based on fundus photographs. The primary outcome was DR, and secondary outcome included DR severity status (i.e., nonproliferative and proliferative), hallmarks of retinal lesions and macular oedema. ResultsA total of 484,380 adult participants with diabetes were included in the current analysis, and 15.7% of them were diagnosed with DR. NDVI was inversely and linearly associated with DR prevalence, and an increment of 0.1 NDVI was associated with a 10% (9%–10%) decrease in DR prevalence. Significant and inverse associations were further found for nonproliferative and proliferative DR, hallmarks of lesions and macular oedema. The association between greenness and DR was stronger among participants who were older, obese, lived in the south, had longer duration of diabetes or did not take antidiabetic medications. ConclusionsThis large-scale nationwide study provides the first-hand epidemiological evidence on the associations of residential greenness with DR. Our findings highlight the importance of residential greenness in alleviating DR risk especially in an era of aging and urbanization.

Pro-Inflammatory diet accounts for higher prevalence of retinopathy in diabetes participants rather than normal glucose and prediabetes: Results from NHANES, 2005-2008.

Retinopathy is a chronic inflammatory disease whose prognosis could be improved with dietary interventions. However, the association between a pro-inflammatory diet and the prevalence of retinopathy has not been fully elucidated. We assess the association between the dietary inflammatory index (DII), which is a comprehensive index determining inflammatory potential derived from food parameters according to literature, and the prevalence of retinopathy based on the data from the National Health and Nutritional Examination Survey (NHANES) 2005-2008 involving 2,403 participants. Energy-adjusted DII (E-DII) was not related to the occurrence of retinopathy in the general, non-diabetic, or middle-aged participants. In the diabetic and aged participants, one unit increment of E-DII accounted for 14 and 15% higher the prevalence of retinopathy respectively. The highest E-DII group had a 78 and 79% higher prevalence of retinopathy than the lowest group respectively. After adjusting for several covariables, the highest E-DII group was still associated with a 68% increase in retinopathy in diabetic patients. These results suggest that E-DII is positively associated with the prevalence of diabetic retinopathy among diabetic patients.

Prevalence and factors associated with Diabetes retinopathy among type 2 diabetic patients at Northwest Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia 2021

IntroductionThe worldwide prevalence of Diabetic Retinopathy was recently estimated to be 34.6%. The prevalence of diabetic retinopathy in developed nations has been thoroughly investigated, and risk factors are well understood. However, there is a shortage of information in the study areas about the prevalence and contributing factors of diabetic retinopathy among type two diabetes patients.ObjectiveThe aim of this study was to assess the prevalence of diabetic retinopathy and associated factor among type 2 diabetic patients who were on follow up services at northwest Amhara comprehensive specialized hospitals diabetic care units.MethodAn institutional based cross-sectional study was conducted at northwest Amhara comprehensive specialized hospitals from October 15 to November 15, 2021, among 496 diabetes patients. Systematic random sampling technique was used. Data were collected by utilizing a semi-structured questionnaire and a direct Topcon retinal camera inspection. Then data were coded, entered, and exported to SPSS version 23 from EPI-Data version 4.6. All variables with P-value < 0.25 in the binary logistic regression analyses were included in the multivariable regression analysis. The degree of association was interpreted by using the adjusted odds ratio with 95% confidence intervals, and the significance level was declared at P-value < 0.05. The Hosmer–Lemeshow test was used to check the fitness of the model.ResultThe prevalence of diabetic retinopathy among type two diabetes patients was 36.3%. Sex [AOR = 3.25, 95% CI (1.80, 6.68)], visiting health institution [AOR = 0.027, 95% CI (0.003, 0.253)], educational level [AOR = 4.23, 95% CI (1.09, 16.47)], glycemic control [AOR = 0.099, 95% CI (0.02, 0.49)], hypertension status (AOR = 2.56, 95% CI (1.01, 6.45)] were significantly associated with diabetic retinopathy.ConclusionIn this study less than half of diabetic patients had diabetic retinopathy. Sex, visiting health institution, educational level, glycemic control, and hypertension status were significantly associated with diabetic retinopathy.

Prevalence of Diabetic Retinopathy in the City of Sarajevo, Bosnia and Herzegovina

Background: The main causes of severe vision loss and blindness in Europe are age-related retinal diseases, particularly age-related macular degeneration (AMD), diabetic eye disease (DED), and a host of vascular conditions. Both the prevalence and incidence of severe vision loss are expected to increase in territories where life expectancy is increasing. Objective: The aim of this study is to estimate the current prevalence of diabetic retinopathy and the most common risks for its development in the city of Sarajevo, a Capital of Bosnia and Herzegovina. Methods: This retrospective single center study included 205 diabetic patients from the city of Sarajevo who attended the regular ophthalmological examination at the Specialty Eye Hospital Svjetlost, in a branch located in the city center, from August 2021 to August 2022. Patients underwent a complete medical assessment by ophthalmology specialists. The retinal examination included an evaluation of the presence of diabetic retinopathy. Any retinopathy present was graded as mild non-proliferative retinopathy, moderate-severe non-proliferative retinopathy, or proliferative retinopathy (PDR). Results: Retinopathy was present in 40.49 % of patients included in this study; 13.17 % had the mild form of diabetic retinopathy, 7.80 % had the moderate-severe form, and 19.51 % had a proliferative form of diabetic retinopathy. The mean duration of diabetes diagnosis was 11.12 years overall, 11.74 years in men, and 10.22 in women. Macular edema was present in 38.55% of patients with retinopathy, 6.02 % in patients with mild form, 8.43 % in patients with moderate-severe form, and 24.09 % in patients with PDR. Conclusion: The prevalence of diabetic retinopathy in Sarajevo is relatively high, and the most common is a severe form of the disease. Regular diabetic retinopathy screening in primary healthcare services and hospital eye services is highly recommended for the timely prevention of visual impairment and blindness.

Progression of Diabetic Retinopathy during COVID-19 Pandemic: A Retrospective Study

Introduction: Emergence and subsequent exponential spread of Coronavirus Disease-2019 (COVID-19) infection during 2020 forced the Government to issue countrywide lockdown from March 2020. Diabetic Retinopathy (DR) is one of the debilitating diseases of the eye which requires regular follow-ups and timely intervention to prevent permanent vision loss. The impact of countrywide lockdown on prevalence and progression of DR needs to be evaluated. Aim: To assess the effect of COVID-19 pandemic situation on the prevalence and progression of DR and analyse the possible risk factors for progression of DR in the ongoing pandemic period by comparing retrospective data from immediate prepandemic quarter with post lockdown quarter. Materials and Methods: This retrospective study was conducted in the Department of Opthalmology at Regional Institute of Ophthalmology, Kolkata, West Bengal, India. The study was done during the prepandemic period, from November 2019 to February 2020. In the present study, a cohort of 83 diabetic patients with pre-existing DR was selected from past medical records and compared with post lockdown period during November 2020 to February 2021. Data regarding prevalence of various types of DR, mean Central Macular Thickness (CMT), mean Visual Acuity (VA), proportion of patients requiring &gt;3 doses of monthly anti-Vascular Endothelial Growth Factors (VEGF) and additional laser therapy or vitrectomy, VA improvement and reduction of mean CMT were gathered and compared between those two quarters. The data was analysed using Statistical Package for Social Sciences (SPSS) version 25.0. Results: The prevalence of moderate Non Proliferative Diabetic Retinopathy (NPDR) (13% vs 25%), severe NPDR (19% vs 8%), Proliferative DR (PDR) (18% vs 7%), Advanced Diabetic Eye Disease (ADED) (4.8% vs 1%) and Diabetic Macular Oedema (DME) (62% vs 28%) increased several folds during post lockdown quarter in comparison to prepandemic quarter. There was a statistically significant difference (p-value&lt;0.05) in baseline mean LogMar Best Corrected Visual Acuity (BCVA) (0.4±0.08 vs 0.9±0.07), mean CMT (386.4±26.8 to 421.8±21.6) positive correlations of some of the possible risk factors for poor visual outcome among the same cohort of patients in the post lockdown period: poor socioeconomic status (35%; Odds Ratio (OR):3.59, Relative Risk (RR):2.68), irregular diabetic medication (52%; OR:3.56, RR:2.23), residence more than 100 km from the hospital (38%; OR:3.03, RR:2.26). Conclusion: The present study, concludes that, the status of DR stage among study subjects in the post lockdown period has deteriorated when compared with the prepandemic period.

Clinical Profile of Nonproteinuric Kidney Disease in Type 2 Diabetic Patients in India.

Diabetic kidney disease (DKD) is the commonest cause of end-stage renal disease (ESRD) across the world. Development of microalbuminuria is the earliest marker of DKD and predicts progressive decline in estimated glomerular filtration rate (eGFR). However, recent evidence has suggested that a significant proportion of type 2 diabetic patients have chronic kidney disease (CKD) without proteinuria. In this single-center, prospective observational study, 400 consecutive type 2 diabetic patients with either overt proteinuria (>500 mg/day) and/or renal dysfunction eGFR <60 ml/min/1.73 m2) were recruited. Baseline demographic and clinical data were recorded. eGFR and proteinuria were recorded at 6 months and 1 year. Patients with proteinuric (proteinuria >0.5 g/day) and nonproteinuric phenotypes were compared for progression of renal dysfunction in terms of doubling of serum creatinine and need for dialysis. In our study cohort, 106 (26.5%) were nonproteinuric. Both the groups were similar in terms of gender, duration of diabetes, comorbidities, body mass index (BMI), blood pressure control, and glycemic control. The nonproteinuric group was older (56.5 ± 2.1 vs. 54.7 ± 11.6 years, P = 0.012), had lesser prevalence of diabetic retinopathy (49 [46.2%] vs. 218 [74.1%], P < 0.001), higher hemoglobin levels (11.3 ± 1.7 vs. 10.5 ± 2.0 g/dl, P < 0.001), and higher cholesterol levels (169.3 ± 43.3 vs 157.1 ± 58.1 mg/dl, P = 0.025). The nonproteinuric phenotype had higher eGFR at baseline, 6 months, and 1 year. However, doubling of serum creatinine (10 [9.4%] vs. 48 [16.3%]) and progression to ESRD (5 [4.7%] vs. 19 [6.5%], P = 0.159) were not different between the two phenotypes. Nonproteinuric DKD is common. Patients with nonproteinuric DKD tend to be older with a slower decline in eGFR.

Mortality and morbidity of extremely low birth weight infants in Japan, 2015.

In Japan, the mortality rate of extremely low birth weight (ELBW) infants is notably low among the developed countries, but the prevalence of chronic lung disease (CLD) and retinopathy of prematurity (ROP) is relatively high. This study aimed to estimate the mortality and morbidity of ELBW infants born in 2015 who were admitted to the neonatal intensive care units (NICUs) in Japan and to examine the factors that affect the short-term outcome of these infants. We also compared the mortality of ELBW infants born in 2005, 2010, and 2015. We analyzed the mortality, morbidity, and factors related to short-term outcomes of ELBW infants, using data of 2,782 infants born in 2015 registered at the NICUs in Japan. Mortality rate during NICU stay was 17.0%, 12.0%, and 9.8% for ELBW infants born in 2005, 2010, and 2015, respectively. Among ELBW infants born in 2015, multiple logistic regression analysis showed that short gestational age and low birth weight Z-score contributed to the increased risk of death. Births by cesarean section and antenatal corticosteroid administration were significantly associated with a reduced risk of death. Among infants who survived, CLD was observed in 53.1% and ROP requiring any treatment was observed in 30.4%. Mortality in ELBW infants decreased significantly from 2005 to 2015. As CLD and ROP may affect the quality of life and long-term outcomes of infants who survived, prevention strategies and management for these complications are critical issues in neonatal care in Japan.

Kidney injury molecule-1 and cystatin C as early biomarkers for renal dysfunction in Iraqi type 2 diabetes mellitus patients

Diabetic kidney disease (DKD) is caused by a variety of processes. As a result, one biomarker is insufficient to represent the complete process. This study Evaluate the diagnostic value of serum kidney injury molecule-1(KIM-1) and cystatin C (CysC) as early biochemical markers of DKD and predictive their sensitivities and specificities as biomarkers of nephropathy in Iraqi type 2 diabetic (T2DM) patients. This cross-sectional study include 161 T2DM patients from Diabetes and Endocrinology Center at Merjan medical city in Babylon. Patients divided according to urinary albumin creatinine ratio(ACR) (Group1:ACR≤30mg/g,Group2:ACR&gt;30mg/g). Random spot urine and fasting blood samples were taken from each patient and urinary ACR, blood glycated hemoglobin(HbA1c), and serum glucose, creatinine(SCr), lipid profile, CysC, KIM-1 were assayed, and the estimated glomerular filtration rat (eGFR) was calculated. When compared to the normoalbuminuric group, the DKD group had significantly greater prevalence of retinopathy, and significantly elevated HbA1c and total cholesterol values. Also had significantly greater serum levels of KIM-1 and CysC, and there is a significant (P-value&lt; 0.01) positive correlation between them. In contrast, GFR was significantly higher in normoalbuminuric group and was significantly negatively correlated with both CysC and KIM-1. Multiple linear regression analysis, found that there were a significant positive association between CysC, KIM-1 and ACR. ROC analysis reveal that eGFR had the highest area under the curve(AUC=0.717), while SCr had the lowest AUC(0.556). In conclusion, Serum KIM-1 and CysC levels consider as early biomarker for DKD along with eGFR that consider the best diagnostic indicator of DKD, Additionally, there is a strong correlation between serum CysC and KIM-1 as well as other renal measures that indicate deteriorating kidney function.

Deep learning system for assessing diabetic retinopathy prevalence and risk level estimation

Diabetic retinopathy, one of the foremost problems brought on by Diabetes Mellitus has seen an exponential rise in incidence due to the exponential growth of diabetics worldwide and causes visual issues and sightlessness owing to deformity of individual retina. An early detection and diagnosis are necessary to stop DR from progressing into severe stages and to stop blindness for which regular screening of eye is mandatory. To do this, several machine learning (ML) models are available. However, when used with bigger datasets, classical ML models either need more training time and have less generalisation in feature extraction and classification than when used with smaller data volumes. As a result, Deep Learning (DL), a newer ML paradigm that can manage a relatively small data volume with aid of effective data processing methods is presented. They do, still, often use bigger data in the deep network structure to improve feature extraction and picture classification performance. This study presents a CNN model for DR classification and compares with other variants of pre-trained DL models for initial recognition of DR through binary and multi-class classification. The attained result of 97% accuracy reveals that pre-trained ResNet model’s efficacy is better in diagnosing DR.

Frequency of Diabetic Retinopathy Amongst Type 2 Diabetes Mellitus Patients

Background: A chronic and debilitating condition called as diabetes is now a global epidemic problem. Patients in our population with 2 diabetes mellitus often develop diabetic retinopathy. Objective: To assess the diabetic retinopathy frequency amongst type 2 diabetes mellitus patients Methodology: The observational study was carried out at Ophthalmology, Department, Qazi Hussain Ahmad Medical Complex, Nowshera from January 2022 to July 2022. Ophthalmoscopy (Both direct and indirect) was done for the retinopathy and was then classified according to standard classification. All the data including age, gender and frequency of retinopathy was documented in a proforma designed for this research. IBM SPSS version 23 was used for data analysis. Results: In the current research, totally 320 type 2 diabetes mellitus patients were enrolled. There were 176 (55%) male patients while female patients were 144 (45%). Mean age (SD) of the enrolled patients in our study was 44 (12.5) years. The mean (SD) diabetes mellitus duration was 5.21 (2.56) years. In type 2 diabetes mellitus patients, the overall diabetic retinopathy frequency was 128 (49%). Conclusion: Our study concludes that the diabetic retinopathy prevalence is very high amongst type 2 diabetic patients. The prevalence of diabetic retinopathy is significantly increased due to lack of awareness and ophthalmic assessment. All the type 2 diabetic individuals should have routine ophthalmic evaluations. Keywords: Frequency; Diabetic retinopathy; Type 2 diabetes mellitus

Prevalence and factors associated with diabetic retinopathy among type 2 diabetic patients in Bangladesh: a hospital based cross-sectional study

Background: Diabetes mellitus is a major health problem in Southeast Asia and diabetic retinopathy is one of its most debilitating complications. Nevertheless, fundoscopy and systematic evaluation of non-adherence to drug therapy are not regularly done in individuals with diabetes in Bangladesh due to limited resources. Therefore, the prevalence of diabetic retinopathy and its determinants with non-adherence to drug therapy are not known. We, therefore, screened for diabetic retinopathy, non-adherence to drug therapy and other associated factors at a tertiary care hospital in Bangladesh.Methods: Between May 2017 to September 2017, we conducted a cross-sectional study of 489 systematically recruited asymptomatic, at least one-year type-2 diabetic individuals on medication and attending the outpatient department of the BIHS tertiary care centre in Dhaka, Bangladesh. We obtained a medical history, physical examination, routine laboratory tests, questionnaires, and fundus photography.Results: The prevalence of diabetic retinopathy among T2DM patients was 18.8%. Clinical factors associated with the presence of diabetic retinopathy were uncontrolled fasting blood glucose, known duration of diabetes of ≥10 years and self-reported non-adherence to drug therapy. With a known duration of diabetes of 15 years or more, the prevalence of diabetic retinopathy rose to 40%.Conclusions: Undiagnosed diabetic retinopathy is still common among patients in Bangladesh, even at tertiary care centres. It is associated with longer disease duration, poor metabolic control and self-reported non-adherence to therapy. Regular screening for diabetic retinopathy should therefore be implemented also in resource-limited settings and further efforts should be made to improve the patients’ drug adherence and metabolic control.

Impact of microvascular complications on the outcomes of diabetic foot in type 2 diabetic patients with documented peripheral artery disease.

Microvascular disease (MVD) is associated with amputation linked to peripheral artery disease (PAD) in the general population. No study evaluated the impact of diabetic microvascular complications on the outcomes of vascular diabetic foot ulcers (DFU). The aim of the study was to investigate whether retinopathy, nephropathy, and polyneuropathy can predict the outcomes of DFU in type 2 diabetic patients with PAD. Three hundred and thirty-one consecutive patients with vascular DFU were enrolled and followed up for 44.1 ± 23.9 months. The prevalence of retinopathy was significantly higher in subjects with ulcer persistence (45.2%; p < 0.01), minor amputation (48.9%; p < 0.001), and major amputation (57.9%; p < 0.001) than in healed patients (23.3%), and in non-survivors than in survivors (64.9 versus 20.5%; p < 0.001). The prevalence of nephropathy was significantly greater in subjects with ulcer persistence (83.9%; p < 0.01), minor amputation (86.7%; p < 0.001), and major amputation (94.7%; p < 0.001) than in those with healed DFU (64.4%), and in non-survivors than in survivors (88.3 versus 65.7%; p < 0.001). The prevalence of polyneuropathy was significantly higher in non-survivors than in survivors (76.6 versus 61.0%; p = 0.012). Multivariate analysis showed that absence of retinopathy (OR: 0.451; 95% CI: 0.250-0.815; p < 0.001) and nephropathy (OR: 0.450; 95% CI: 0.212-0.951; p = 0.036) were independently associated with healing. Moreover, retinopathy was a predictor both of minor amputation (OR: 2.291; 95% CI: 1.061-4.949; p = 0.034) and mortality (OR: 5.274; 95% CI: 2.524-11.020; p < 0.001). Polyneuropathy never entered the regression model. Diabetic microvascular complications, in particular retinopathy, may predict the outcomes of vascular DFU. Longitudinal studies should confirm this finding.

Fenofibrate for the prevention of progression of non-proliferative diabetic retinopathy: review, consensus recommendations and guidance for clinical practice.

The prevalence of diabetic retinopathy (DR), and associated morbidity is high in the Asia-Pacific region. Emerging evidence suggests a potential role for fenofibrate in the prevention of progression of DR, especially in patients with cardiovascular risk, and pre-existing mild-to-moderate DR. Fenofibrate has also been found to reduce maculopathy, and the need for laser treatment in these patients. Considering these benefits of fenofibrate, a group of experts from the fields of endocrinology and ophthalmology convened in May 2017, to discuss on the the mechanism of action, and clinical efficacy of fenofibrate in DR. The findings from key clinical studies on fenofibrate in DR were reviewed by the experts, and consensus statements were derived to define the role of fenofibrate in the prevention and treatment of DR. The statements were rated based on the GRADE criteria. An algorithm was also developed for the screening and treatment of DR in patients with type 2 diabetes (T2D), and the place of fenofibrate was defined in the algorithm. The expert recommendations, and the algorithm provided in this review will serve as a guide to the clinicians to reconsider the adjunctive use of fenofibrate for preventing the progression of DR in selected T2D patients.

STUDY OF ASSOCIATION BETWEEN HYPERTENSIVE RETINOPATHY AND VARIOUS LIPID PARAMATERS IN PATIENTS OF ESSENTIAL HYPERTENSION VISITING TERTIARY EYE HOSPITAL IN SOUTHERN INDIA

Aim: To study the association of components of lipid profile with hypertensive retinopathy in patients of essential hypertension. Materials and Methods: A Cross Sectional Study was carried out in 80 patients who were diagnosed to have systemic Hypertension. Patients having myopia, having diabetes, hazy ocular media, and other retinal problems were excluded from the study.A detailed examination of patient's hypertensive status was done by physician after ruling out secondary causes of hypertension. Full ophthalmological examination was carried out. All the patients were investigated for fasting serum lipid profile. Results: Out of the 80 patients with essential hypertension, 55 (55%) had retinopathy and the remaining 25 (25%) subjects had no retinopathy were mainly concentrated in the 6th decade (69.70%), increasing thereafter up to 83.78% who were over 60 years of age. This shows the increasing prevalence of hypertensive retinopathy with increasing age.No sex preponderance toward developing retinopathy was found in this study . A positive correlation of hypertensive retinopathy was found with total cholesterol (P &lt; 0.002), low-density lipoprotein (LDL)-cholesterol (P &lt; 0.0001),Serum triglycerides (P &lt; 0.01),and an low-density lipoprotein:high-density lipoprotein (LDL:HDL) ratio (P &lt; 0.002).Conclusion: The duration of hypertension was found to be strongly associated with development of hypertensive retinopathy.This study proved a definite association between serum lipid parameters and prevalence of hypertensive retinopathy.

Diabetic Retinopathy and Associated Risk Factors Among Diabetic Patients Attending Eye Camps In Northern Bangladesh

Background: Diabetic retinopathy (DR) is one of the leading causes of vision loss which occurs as a result of microvascular complication of diabetes. The aim of the study is to assess the prevalence and factors associated with development of diabetic retinopathy among diabetic patients attending eye camps in a diabetic hospital of northern Bangladesh. Methods: This was a population-based cross-sectional study, conducted through five comprehensive eye camps at diabetic association hospital in Nilphamari, Bangladesh. Previously diagnosed patients with Diabetes Mellitus attending eye camps were the sample of this study which included a total of 254 participants. All participants underwent complete eye examination to check for any signs of DR with any other ocular abnormalities. Retinopathy was determined by fundus photography and direct ophthalmoscopy. Participants were also interviewed and examined to determine their demographic characteristics, clinical conditions, awareness on diabetic retinopathy and regularity of their eye visits. Results: A total of 254 subjects were screened for diabetic retinopathy. Of them, 64 (25.2%) had diabetic retinopathy including, including 53 (20.9%) with non-proliferative retinopathy (NPDR) and 11 (4.3%) with proliferative diabetic retinopathy (PDR). Clinically significant macular edema (CSME) was detected in 7 patients (2.7%). The prevalence of diabetic retinopathy was higher among patients with greater duration of diabetes (p=&lt; 0.001), poor glycemic control (p=0.002) and presence of hypertension (p=0.05). Conclusion: Regular screening in patients with diabetes for early detection of diabetic retinopathy by effective screening program and increasing public awareness are highly recommended in Bangladesh. JOPSOM 2021; 40(2):16-25

Influence of hepatitis B virus on the prevalence of diabetes complications in patients with type2 diabetes.

Diabetes and hepatitis B are both global problems. The influence of diabetes on complications and prognosis of hepatitis B has been widely studied. However, the association between hepatitis B virus (HBV) infection and the prevalence of diabetes-related complications is less documented and is uncertain. This was a retrospective study. We collected information from a large clinical database. A total of 1,090 Chinese inpatients with type 2 diabetes were included. The participants were divided into two groups, including 135 patients with HBV infection and 955 patients without HBV infection. Patients with HBV infection were younger and had worse control of blood glucose than those without HBV infection. No significant difference was found in the prevalence of diabetic retinopathy, neuropathy, nephropathy, diabetic ketosis or diabetic ketoacidosis between the patients with HBV infection and the patients without HBV infection. The prevalence of macrovascular complications was 54.1% and 64.4% in diabetes patients complicated with HBV infection and without HBV infection, respectively. The P-value was <0.05. However, through the logistic regression analysis, we found HBV infection was not an independent risk factor for macrovascular complications of diabetes. There was no significant correlation between the prevalence of macrovascular complications, microvascular complications of diabetes, diabetic ketosis or diabetic ketoacidosis and HBV infection status.

Are Insulin Mimetics Protective Against Comorbidity in Patients With Neuro-Autoimmune Disease?

Objective To investigate the neuroprotective potential of insulin mimetics (IM) in patients with neuro autoimmune disease (NAD) and high risk comorbidities. Background IM are used to treat patients with diabetes mellitus (DM) and have been shown to protect against progressive neurological damage. Despite their neuroprotective benefits, the extent of their neuroprotection in patients with NAD has not been completely characterized. Design/Methods A retrospective analysis on 34464 patients hospitalized at a tertiary care center in a major metropolitan area was conducted. 168 patients were taking IM medications. 7848 patients were taking medicine other than IM for their DM (nIM). 7690 patients were taking insulin without IM medications. 26448 patients were not on any DM medication (nDM). The outcomes compared included the prevalence of NAD, diabetic neuropathy and/or retinopathy (DMNR), and the prevalence of high risk comorbidities defined as those with either heart failure, chronic kidney disease, stroke, or encephalopathy. Results The prevalence of NAD was 0.6%, 0.52%, 0.53%, 0.56% among patients in the IM, nIM, insulin, and nDM groups respectively (p &gt; 0.05). 19.5% of NAD and 23.6% of those without NAD had high risk comorbidities (p &gt; 0.05). Among those with autoimmune disease, 31% of those taking any diabetic medication and 16% of nDM had high risk comorbidities (p &gt; 0.05). The prevalence of DMNR was 10% and 8% in IM and nIM groups respectively (p &gt; 0.05). Conclusions These results suggest that IM medications may benefit patients with NAD against additional comorbidity as those without NAD and DM are expected to have less high risk disease. However, more studies are needed to determine whether IM medications play a role in neuro-autoimmune disease progression and mortality. A limitation of this study is that data was collected from a single institution and does not represent the general population.

Hypertension crisis as the first symptom of renovascular hypertension in children

BackgroundRenovascular hypertension (RVH) is one of the main causes of hypertensive crisis (HTN-C). It is characterized by acute onset and severe disease, and early diagnosis and treatment are difficult. The objective was to describe the characteristics of RVH and factors associated with RVH leading to HTN-C in children. At present, there are few clinical studies on RVH in children with large cases in China.MethodsThis study retrospectively analyzed the clinical data of inpatient children with RVH. Patients were divided into non-hypertensive crisis (non-HTN-C) group, and HTN-C group according to the first symptoms and blood pressure. Further, HTN-C were classified as hypertensive urgency (HTN-U) or hypertensive emergency (HTN-E).ResultsFifty-four pediatric cases (41 boys and 13 girls) were included. 83.3% of the RVH cases were ≥ 6 years old. Three cases were classified into the non-HTN-C group. Of the 51 HTN-C cases, 18 cases were grouped as HTN-U and 33 as HTN-E. The HTN-U group were mainly asymptomatic (50.0%, 9/18) while the HTN-E group mainly presented with neurological symptoms (72.7%, 24/33). The number of unknown etiology children was 32 (59.2%). The top three known etiologies were Takayasu’s arteritis (50.0%, 11/22), congenital renal dysplasia (27.3%, 6/22) and fibromuscular dysplasia (13.6%, 3/22). As for the target organ damage of RVH, patients had a higher prevalence of left ventricular hypertrophy (71.4%, 35/49) and retinopathy (77.8%, 21/27).ConclusionsMost RVH patients with HTN-C as the first symptoms, especially for males over 6 years old, should be assessed for RVH even if they were asymptomatic. Most asymptomatic patients with RVH already had target organ damage, and symptomatic patients even developed life-threatening complications. As preventive measures, routine monitoring of BP during children’s physical examinations is advised.

Cluster analysis of Thai patients with newly diagnosed type 2 diabetes mellitus to predict disease progression and treatment outcomes : A prospective cohort study

IntroductionType 2 diabetes mellitus (T2D) is highly heterogeneous in disease progression and risk of complications. This study aimed to categorize Thai T2D into subgroups using variables that are commonly available...

PREVALENCE OF RETINOPATHY IN NEWLY DIAGNOSED DIABETES MELLITUS: EXPERIENCE AT OUR TERTIARY CARE CENTER

Diabetic retinopathy is leading cause of blindness in most of the diabetic population To detect prevalence of diabetic retinopathy at the time of Aim: diagnosis of diabetes mellitus and to study the relationship of development of retinopathy with various risk factors associated with type II diabetes mellitus like BMI and lipid prole. It was a cross-sectional study conducte Methodology: d over a period of one year. Patients with newly diagnosed Type II Diabetes mellitus with age more than 20 years presenting to our department were included in the study. History of blurred vision, black spots, oaters and sudden visual loss taken. Fundus examination was done. Blood investigations included fasting glucose, Postprandial glucose, HbA1c levels and urea &amp; serum creatinine levels were done. A tot Results: al of 100 patients were included. Most of patients were clustered between 31-50 years of age. 41% of the patients were overweight, 27% of the patients were obese. 96% of the patients had no signicant clinical history pertaining to diabetic retinopathy. 56% of the patients had abnormal lipid prole, among the patients with abnormal lipid prole. 6% of patients had abnormal retinoscopy ndings, of which 4 patients had mild NPDR. Out of 57 patients with HbA1C &gt;7.5% , 6 patients had diabetic retinopathy. Diabetic retinopathy is associated with vision thre Conclusion: atening complication. It can be made out even at the time of diagnosis of type II diabetes mellitus.