Title: Study of the Incidence of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus and Ischeamic Heart Disease
Authors: Dr Debapriya Datta, Dr O K Radhakrishnan, Dr Madhuri Sarkar, Dr Priti
DOI: http://dx.doi.org/10.18535/jmscr/v4i6.50
Introduction: Diabetes mellitus (DM) is a metabolic disorder characterised by raised blood glucose level and diabetic retinopathy is a vascular disorder which affects the microvasculature of the retina. Diabetic retinopathy can occur in both type 1 and type 2 DM . Type2 DM is a very important independent risk factor for development of cardiovascular disease, stroke, peripheral arterial disease, cardiomyopathy and congestive heart failure (CHF). These macrovasular complications are one of the leading causes of deaths in the world. The impact of glycaemic control in reducing micro vascular complications has been well established. Although controversial, there is evidence that glycaemic control can limit macrovasular disease including cardiovascular disease, stroke and peripheral arterial disease. The purpose of doing the study is to find out if there is a greater occurrence of Ischaemic Heart Disease (IHD) in patients of diabetic retinopathy and if the more severe stages of diabetic retinopathy are associated with increased occurrence of IHD. Since IHD is a macrovascular complication of DM and diabetic retinopathy is a microvascular complication of DM, we would like to know if there is a correlation between the two. Aims And Objective 1. Study the incidence of diabetic retinopathy in patients with type 2 DM 2. Study the incidence of diabetic retinopathy in patients with type 2 DM and ischemic heart disease 3. Establish relationship between diabetic retinopathy and ischemic heart disease 4. Establish if DR is a valid predictor of ischemic heart disease Materials And Method: A cross sectional observational study was conducted in Padmashree. DR. D. Y. Patil medical college, hospital and research center, Pimpri, Pune after the approval by institutional ethical committee. A total of 320 patients were studied. Inclusion criteria Patients of age between 40 to 70 years with h/o type2 DM for at least 5 years duration and ECG evidence of IHD. Exclusion criteria patients with any other systemic illness, patients with hazy media preventing visualisation of fundus, myopia, h/o eye surgery , h/o laser photocoagulation or any other ocular pathology. The selected patients were divided into 2 groups: Group A: 50 eyes of type 2 DM with diabetic retinopathy but without IHD Group B:50 eyes of type 2 DM with diabetic retinopathy and with IHD HBA1C, blood urea, serum creatinine, serum lipids and BP was recorded for all patients. Conclusion: In our study, we found the incidence of diabetic retinopathy to be 14.2%.there was no significant difference in the types of retinopathy between the two study groups. there was no significant difference between sex distributions in both groups. there was no significant difference in age amongst the two groups. Keywords: Diabetic retinopathy, Type 2 diabetes mellitus, Ischaemic heart disease, blood glucose, HbA1c
Abstract