Bhaskar Balasundaram1, H. R. Surendra2
OBJECTIVE
The study objective was to examine the effect of glycaemic control and variations on the incidence and progression of diabetic retinopathy (DR) among the diabetes mellitus patients visiting Medicine and Ophthalmology OPD Sapthagiri Medical college, Bangalore.
MATERIALS AND METHODS
10 patients with type 1 diabetes mellitus, and 70 persons with type 2 diabetes mellitus, visiting the Medicine OPD of Sapthagiri Medical College and referred to Ophthalmology department of the above to detect the Diabetic Retinopathy changes in a diabetes mellitus management programme conducted for 3 months in Bangalore, participated in the study. Patients who were followed up for 6 months the same above were also included in the study. Analyses were conducted to assess the relationship between the risk factors, incidence and progression of Diabetic Retinopathy among Diabetes Mellitus patients and management.
MAIN OUTCOME MEASURES
To determine the risk factors associated with it, stage of retinopathy diagnosed at presentation, management of it, and final visual outcome. The prevention is by strict glycaemic control, prompt use of anti-diabetic drugs and regular exercises. These included age and gender-adjusted prevalence of diabetes and diabetic retinopathy, 1 and correlation of prevalence with history-based risk factors.
RESULTS
The three months cumulative incidence of DR was 58 %in type I diabetes mellitus and 42 % among type II Diabetes mellitus. After controlling for known risk factors for DR,1 a high baseline haemoglobin A1c (HbA1c), ethnicity, age, type of diabetes mellitus, duration were associated with the incidence of referable DR in patients with type 1 and type 2 diabetes mellitus. The age- and gender-adjusted prevalence rate of diabetes in urban Bangalore 28.2% (95% confidence interval [CI]), and the prevalence of diabetic retinopathy in general population was 3.5% (95% CI). The prevalence of diabetic retinopathy in the population with diabetes mellitus was 18.0% (95% CI). History-based variables that were significantly associated with increased risk of diabetic retinopathy included gender (women at greater risk 56.25%) use of insulin increases the probability of DR;2 longer duration of diabetes 15 years showed increase of DR; and subjects with known family history of diabetes mellitus. Differences in the socioeconomic status2 did not influence the occurrence of diabetic retinopathy.
CONCLUSION
It was revealed in the first study to report on the incidence and progression of DR in Bangalore that a high baseline HbA1c, ethnicity, and the presence of DR increased the risk of the development of other complications of the Diabetes mellitus among diabetics. The prevalence of diabetic retinopathy was 18% in an urban population with diabetes mellitus.
