Study of correlation of risk factors with sternness of diabetic retinopathy

Abstract

Introduction: Diabetes mellitus is a complex metabolic disease caused by a variable interaction between hereditary and environmental factors. The clinical syndrome is defined by hyperglycemia, microvascular abnormalities (retinal and renal) and neuropathy. Its main features are abnormal insulin secretion, high levels of blood glucose and a variety of complications such as nephropathy, retinopathy, neuropathy and arteriosclerosis.Materials and Methods: The inclusion criteria for this study were: no previous treatment for the retinopathy such as photocoagulation, patients had to be older than 15 years and eyes with clear media to facilitate fundus examination and fundus photography. All diabetic patients meeting the inclusion criteria were enrolled at the Govt Medical College, Baramulla. All patients were informed about the purpose of this investigation and signed an informed consent prior to enrolment in this study.Results: 162 patients were selected and evaluated after meeting the inclusion criteria. The age of patients varied from 20 to 78 years old (average 57.91±11.09 years). Results considered statistically significant were p <0.02. Stronger associations were found between severity of retinopathy (group B) and longer time of diabetes (p <0.001), greater values of fasting blood sugar (p =0.11), HbA (1c) (p =0.001) and total serum cholesterol (p =0.019). The severity of diabetic retinopathy was also strongly associated with lower values of hematocrit (p =0.004), presence of proteinuria (p <0.05) and hemoglobin (p =0.001). There was no statistical correlation between the severity of retinopathy and the following: age, LDL, HDL, triglycerides, high blood pressure, plasma creatinine and magnesium. Visual acuity of group B patients was considerably lower than that of patients of group A (p <0.001).Conclusion: The severity of diabetic retinopathy in the studied group was influenced by factors such as duration of disease, type of diabetes, good glycemic control, hematocrit and hemoglobin levels, total serum cholesterol and nephropathy. Factors that apparently did not increase the risk for diabetic retinopathy were age, gender, systemic hypertension and hypomagnesemia.