Prevalence and risk factors for diabetic retinopathy in prediabetes in Asian Indians

Identification of Risk Factors for the Development of Diabetic Retinopathy Among Palestinian Adults With Type 2 Diabetes Mellitus: A Cross-Sectional Study

INTRODUCTION

Although risk factors linked to diabetic retinopathy (DR) among patients with Type 2 diabetes mellitus (T2DM) have been extensively studied globally, the specific determinants of these factors in relation to DR in Palestine are presently not well understood.

METHODS

This retrospective cross-sectional study included patients who underwent DR screening with a fundus camera (VersaCam a). The study included patients aged ≥18 with T2DM, excluding those with other types of diabetes or a history of malignancies. Univariable and multivariable logistic regressions were used to identify factors associated with DR.

RESULTS

A total of 1163 patients with T2DM were included in this study. Of these, 211 (18.1%) patients were classified in the DR group, 761 (65.4%) in the no DR group and 191 (16.4%) were ungradable. Among the included patients, 434 (37.3%) were male. A secondary level of education or higher and a BMI ≥30 kg/m2, compared with <25 kg/m2, were independently and inversely associated with DR, with odds ratios (ORs) of 0.46 (p < 0.001) and 0.58 (p = 0.046), respectively. A 5-year increase in the duration of T2DM correlated with 45% higher odds of having DR (p < 0.001). Patients with DR were more likely to have HbA1c >7%, be physically inactive and use insulin, with ORs of 1.63 (p = 0.02), 2.05 (p < 0.001) and 1.53 (p = 0.03), respectively. Age, gender, occupational status, hypertension and hyperlipidaemia were not independent predictors of DR (p < 0.05).

CONCLUSION

Longer duration of T2DM, HbA1c >7%, physical inactivity and insulin use were all independently associated with the presence of DR. Furthermore, a secondary or higher educational level and obesity demonstrated independent and inverse associations with the development of DR.

Prevalence of Retinopathy in Prediabetic Populations: A Systematic Review and Meta-Analysis

Among the leading causes of vision impairment and blindness globally, diabetic retinopathy (DR) is one of the most important causes. There is increasing evidence of DR prevalence in the prediabetic population. This systematic review presents collective data on retinopathy in the prediabetic population. This review article aimed to estimate the reported prevalence of retinopathy in prediabetes, impaired glucose tolerance test (GTT) without diabetes mellitus, and the risk factors involved and to summarize it. Literature searches were done using the Web of Science, CINAHL, Google Scholar, Cochrane, EMBASE, and PubMed databases from inception to April 2023. Our search included the words prediabetes, DR, and risk factors. All searches were looked at for methodological quality and evidence. Thirty-one studies were included after the screening. Population-based data were used in 23 studies (82.1%). The prediabetic population screened was 10,539. The prevalence of retinopathy ranged between 0.3% and 20.9%, showing a median of 8.1% with an interquartile range (IQR) of 4.2-11%, showing great variance in estimates due to the use of different screening methods, methods used for retinopathy grading, and study populations. Several studies compared the population with normal GTT with impaired glucose tolerance (IGT) and inferred that there was a lower prevalence of retinopathy in the normal GTT population (3.0%, IQR 0.3-7.4%) than prediabetes (6.7%, IQR 1.9-10.1%). According to this data, a greater retinopathy prevalence was found in prediabetic populations.

Risk Factors for Diabetic Retinopathy in Chinese Patients with Different Diabetes Duration: Association of C-Peptide and BUN/Cr Ratio with Type 2 Diabetic Retinopathy

Background and Aim

Controlling the risk factors was the most effective strategy to prevent diabetic retinopathy (DR). This study aimed to recognize the risk factors of DR, and explores whether the effect of those factors is modified by diabetes mellitus (DM) duration.

Methods

A total of 1058 DM patients with information about DR assessment were included. DR was measured by a complete ophthalmic examination and was classified as having one or more distinct microaneurysms in the eyes. Data from the lab and clinical factors were gathered. Multivariate logistic analysis was used to examine the risk factors, and the best-fitting model was selected by a backward stepwise based on A1C.

Results

In the current study, 274 (25.9%) patients developed DR. In the entire subjects, baseline age, the level of C-peptide, and urinary creatinine were all presented as protective effects of DR, whose odds ratios (ORs) and 95% confidence intervals (CIs) were 0.79 (0.62, 0.99), 0.75 (0.61, 0.91), and 0.70 (0.52, 0.93), respectively. Conversely, systolic pressure (SBP), urinary albumin, and BUN/Cr ratio were the important risk factors for DR with ORs (95% CIs) 1.21 (1.01, 1.46), 1.55 (1.30, 1.84), and 1.33 (1.11, 1.59), respectively. In stratification analysis, females with higher SBP would be more likely to develop DR in the short-duration group, while C-peptide and urinary creatinine showed protective effects in the long-duration group. BUN/Cr ratio all presented as a risk factor, with ORs 1.38 (p = 0.041) and 1.33 (p = 0.014) in short- and long-duration groups, respectively.

Conclusion

Although renal functions presented a significant association with DR in all DM patients, the risk factors of DR varied widely in different disease-duration subjects. Target strategies to prevent DR should be put forward individually, considering the patient's DM duration. Improving the BUN/Cr ratio may be beneficial to delaying DR.

Diabetic Retinopathy among Patients with Prediabetes Attending the Outpatient Department of Ophthalmology in a Tertiary Eye Care Centre: A Descriptive Cross-sectional Study

INTRODUCTION

Diabetic retinopathy is a specific microvascular ocular complication associated with diabetes. However, retinopathy has also been reported in people with prediabetes. The study aimed to find out the prevalence of diabetic retinopathy among patients with prediabetes attending the outpatient Department of Ophthalmology in a tertiary eye care centre.

METHODS

A descriptive cross-sectional study was conducted among patients with prediabetes attending the outpatient Department of Ophthalmology in a tertiary eye care centre from 1 January 2022 and 30 April 2022. Ethical approval was obtained from the Ethical Review Board (Registration number: 594/2021 P). All patients had their eyes dilated and examined under the slit-lamp with a 90 D convex lens or indirect ophthalmoscopes with a 20 D lens to find retinopathy. All patients aged 40 to 79 years with intermediate hyperglycemia were included in the study. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated.

RESULTS

Among 141 patients with prediabetes, diabetic retinopathy was found in 8 (5.67%) (1.85-9.49, 95% Confidence Interval). Among which all patients 8 (5.67%) had mild non-proliferative diabetic retinopathy. Among patients with retinopathy, all 8 (5.67%) were obese, 3 (37.50%) were hypertensive, 5 (62.50%) patients had intermediate hyperglycemia for more than 6 months, and 2 (25%) had a family history of diabetes mellitus.

CONCLUSIONS

The prevalence of diabetic retinopathy in prediabetes patient was found to be higher than the other studies conducted in similar settings.

KEYWORDS

diabetic retinopathy; prediabetes; prevalence.

Dietary Consumption on Glycemic Control Among Prediabetes: A Review of the Literature

Introduction

Prediabetes is a condition that, if left unaddressed, can lead to various complications, such as neuropathy, retinopathy, and nephropathy. Among the critical factors contributing to the development of type 2 diabetes mellitus, dietary choices stand out as particularly significant.

Objective

Consequently, our objective is to examine the latest research findings concerning dietary consumption and its impact on glycemic control in individuals with prediabetes.

Methods

A literature review of randomized controlled trials was performed using databases such as PubMed, Scopus, and ScienceDirect with searches conducted from January 2019 to 2023. The primary reviewer assessed the quality of the selected studies for bias risk using the Joanna Briggs Institute critical appraisal method for randomized controlled trials. Initially, 975 articles were identified through the search, but after applying the inclusion criteria, only 9 articles were ultimately selected.

Results

The review found that a carrageenan-free diet, yogurt with Lactobacillus plantarum OLL2712, Allium hookeri extract (AHE), and delta-tocotrienol improve HbA1C levels. However, salmon, zinc supplement, and balanced deep-sea water were not effective on HbA1C. In addition, studies on the effectiveness of vitamin D in controlling blood glucose levels are inconsistent.

Conclusion

Nurses can enhance patient outcomes through collaborative efforts to create individualized dietary strategies. These strategies may encompass the adoption of a carrageenan-free diet, the inclusion of L plantarum OLL2712-enriched yogurt, the utilization of AHE, and the integration of delta-tocotrienol into the dietary plan. This approach is particularly applicable to ambulatory care nurses, health supervisors, and primary care providers.

Diosgenin: An ingress towards solving puzzle for diabetes treatment

The consumption and composition of food in daily life predict our health in long run. The relation of diabetes to sweets is quite popular. Diabetes hampers the glucose and insulin regulation in the human body by damaging pancreatic β cells. Diabetes has a strong potential towards altering cellular mechanisms of organs causing unlawful performance. Diabetes alters pathways like TLR4, AChE, NF-ĸB, LPL, and PPAR at different sites that affect the normal cellular machinery and cause damage to the local tissue and organ. The long-lasting effect of diabetes was observed in vascular, cardia, nervous, skeletal, reproductive, hepatic, ocular, and renal systems. The increasing awareness of diabetes and its concern has awakened the common people more enthusiastically. Due to rising harm from diabetes, scientific researchers tend to have more eyes toward it. While searching for diabetes solutions, fenugreek diosgenin could pop up with some positive effects in curing the same. Diosgenin helps to lower the scathe of diabetes by modifying cellular pathways in favor of healthy bodily functions. Diosgenin altered the pathways for renewal of pancreatic β cells for better insulin secretion, initiate GLUT4, enhanced DHEA, modify ER-α-mediated PI3K/Akt pathways. Diosgenin can be an appropriate insult for diabetes in a much evolving way for a healthy lifestyle. PRACTICAL APPLICATIONS: Diabetes is one of the most death causing diseases in the medical world. Regrettably the cure of diabetes is yet to be found. Various scientific team working on the same to look after the most appropriate way for diabetes treatment. There is enormous growth of nutraceutical in the market claiming for cure of different metabolic disorders. Among various bioactive compound fenugreek's diosgenin could took a leap over other in curing and preventing the damage caused by diabetes to different organs. The role of diosgenin in curing various metabolic disorders is quite popular from some time. This article also emphasizes over beneficiary effect of diosgenin in curing the damages caused by diabetes by altering cellular metabolism processes. Hence diosgenin could be a better way for researchers to develop a method for diabetes treatment.