Artikel
The association between glycosylated hemoglobin level and the stage of diabetic retinopathy at first presentation
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Autoren
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J. K Shrestha
- BPkoirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University, Nepal
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M. Karki
- BPkoirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University, Nepal
| Veröffentlicht: | 18. September 2006 |
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Gliederung
Text
Background
Diabetic retinopathy is an important complication in diabetic population. Intervention early is the course of diabetic prevents or delays onset of retinopathy. 5-year risk of severe visual loss from untreated high-risk proliferative diabetic retinopathy is as high as 60%. Present standards of care reduce risk of severe vision loss from DR to less than 2%. Therefore, the current challenge is to identify and assess all diabetic persons for evaluation and treatment. The aim of this study is to determine the association of the level of glycosylated hemoglobin to the stage of retinopathy at first presentation.
Methodology
This is a cross-sectional, descriptive and prospective study. All diabetic with a history of diabetes for less than 10 years duration were included in the study.
Modified Airlie House (ETDRS- Based Clinical Diabetic Retinopathy Disease Severity Scale) was followed to grade the stage of retinopathy. Glycosylated hemoglobin level was assessed in cases.
Result
There were a total of 140 patients (280 eyes) of which 23.6% had diabetic retinopathy in the right eye (RE) and 22.1% in the left eye (LE). Maximum number of patients was in the age group 51-60 years (32.1%) with mean of 52.6±11.0 SD. Diabetic was seen in highest frequency in housewives (42.1%) followed by servicemen (25%).
The mean duration of diabetes was 4.2±3.2 SD with highest number of patients with duration of 0-2 years followed by ≥2-4 years. Association with hypertension was seen in 29.3% of patients. The mean glycosylated hemoglobin level was 6.6±1.0 SD. Glycosylated hemoglobin level was normal (4.2-6.2%) in 3.9% of patients followed by good control (6.3-6.8%) in 27.1% of patients.
The stage of diabetic retinopathy according to glycosylated hemoglobin level was statistically significant in the normal level (p= 0.009) and poor control group (p=0.001). The correlation between the stage of diabetic retinopathy and duration of diabetes was significant in the 8-10 years duration group in both RE (p=0.003), LE (p=0.007) and both (p=0.001). The correlation between the stage of diabetic retinopathy and duration of diabetes was significant in the 8-10 years duration group in both RE (p=0.003) and LE (p=0.0007).
Conclusion
A significant association is seen between the duration of diabetes and the level of glycosylated hemoglobin with the stage of retinopathy. It was observed that normal HBAlc and awareness had very minimal mild retinopathy in comparison to those with poor HBAlc and awareness group.
