ROLE OF GLYCEMIC CONTROL IN DEVELOPMENT OF DIABETIC RETINOPATHY

Abstract

Background; Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM) and is considered the leading cause of visual impairment in working-aged adults worldwide. The duration of DM and hyperglycemia have been associated with DR, so this study was done to ascertain role of glycemic control in the development of diabetic retinopathy. Objective; To compare the frequency of DR in in type II diabetes having controlled and un-controlled diabetes. Subjects and Methods; A total of 175 type 2 diabetic patients presenting in Diabetes OPD aged 35 – 65 years were selected in this cross-sectional study from Diabetes outdoor clinic of Nishtar Hospital Multan. Patients underwent any form of retinal surgery / laser therapy, on ACE-inhibitors or ARBs, having cataract were excluded from our study. All patients had undergone retinal imaging using Non Mydriatic Fundus Camera (NIDEK^® Model # AFC-330) and collected data was analyzed by SPSS version 22. Results; Of these 178 study cases, 73 (41.0 %) were male patients while 105 (59.0 %) were female patients. Mean age of our study cases was 50.39 ± 8.25 years. Mean age of the male patients was noted to be 57.36 ± 5.25 years while that female patients was 45.54 ± 6.24 years (p=0.000). Mean body mass index of our study cases was 26.12 ± 1.85 kg/m² and obesity was present in 45 (25.3 %) of our study cases. Mean disease duration was 6.23 ± 3.28 years and 92 (51.7%) had duration of illness more than 5 years. Of these 178 study cases, 112 (62.9%) were illiterate and 66 (37.1%) were literate. Diabetes was controlled in 79 (44.4%) while it was un-controlled in 99 (55.6%) of our study cases. Diabetic Retinopathy was noted in 69 (38.8%) of our study cases. Diabetic retinopathy was 22.8% patients with controlled diabetes and 51.5% in patients with un – controlled diabetes. Conclusion; Very high frequency of diabetic retinopathy was noted in our study among diabetic patients having un-controlled diabetes as compared with those having controlled diabetes. Diabetic retinopathy was significantly associated with control of diabetes, residential status and prolonged disease duration. National health authorities must launch a mega awareness campaign at national level for awareness of diabetic patients leading to good glycemic control which will protect them from future hardships.

Keywords; Diabetic retinopathy, controlled diabetes, frequency.