Predictors of Diabetic Retinopathy in patients with Type 2 Diabetes Mellitus with Normoalbuminuria

Irsath, S (2015) Predictors of Diabetic Retinopathy in patients with Type 2 Diabetes Mellitus with Normoalbuminuria. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION: Diabetes mellitus, one of the important non communicable diseases in our country and has become major health concern in recent times. Microvascular disease is a common complication in type 2 diabetes and diabetic retinopathy (DR) and nephropathy represent leading causes of visual impairment and end stage renal disease respectively in adults of both developed and developing world. Patients with type 2 diabetes may have Diabetic Retinopathy without microalbuminuria. Various studies have shown risk factors for DR that include hypertension, longer duration of diabetes and anemia. This has been supported by several studies reporting 10‑30% prevalence of DR in type 2 diabetes with normoalbuminuria. Hence, early identification and correction of these predictors are necessary to avoid sight threatening complications due to diabetic retinopathy. AIMS AND OBJECTIVES: To estimate the prevalence of Diabetic Retinopathy in patients with Type 2 Diabetes Mellitus who have normoalbuminuria. To study the predictors (Anemia, Duration of Type 2 Diabetes Mellitus, Hypertension) of Diabetic Retinopathy in patients with normoalbuminuria. MATERIALS AND METHODS: STUDY POPULATION: This study was conducted among 100 patients with Type 2 Diabetes Mellitus attending Department of General Medicine in Govt. Rajaji Hospital, Madurai. STUDY PROTOCOL: This study is done in 100 type 2 diabetes mellitus patients. Patients are first performed renal function test and microalbumin in urine. Patients with normal renal function test and normoalbuminuria are selected. Then they undergo haemoglobin estimation, measurement of blood pressure and history of duration of type 2 diabetes mellitus are elicited. Now the patient undergoes fundus examination and screening for diabetic retinopathy is done. Then the prevalence of diabetic retinopathy and the predictors of diabetic retinopathy in patients with normoalbuminuria are calculated. RESULTS: In our study, the diabetic retinopathy estimated prevalence in patients with normoalbuminuric type 2 diabetes mellitus is around 40%. Hence in normoalbuminuric type 2 diabetes individuals, presence of other predictors like anemia (Hb < 8 gms), systemic hypertension and longer duration of diabetes can identify the individuals with diabetic retinopathy which was statistically significant in our study. CONCLUSIONS: In patients of type 2 DM, inspite of normoalbuminuria diabetic retinopathy is very much common. Absence of albuminuria should not be the criteria to defer for screening of diabetic retinopathy. Various predictors for the determination of DR are the estimated levels of haemoglobin, diabetes duration, and associated systemic hypertension. Hence, even in type 2 diabetes patients with normoalbuminuria, presence of other predictors like low haemoglobin, systemic hypertension and longer duration of diabetes can identify high risk individuals who develop diabetic retinopathy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Type 2 Diabetes Mellitus ; Normoalbuminuria ; Diabetic Retinopathy ; Anemia ; Systemic Hypertension ; Longer duration of Diabetes.
Subjects: MEDICAL > General Medicine
Depositing User: Punitha K
Date Deposited: 18 May 2018 18:52
Last Modified: 18 May 2018 18:52

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