Microvascular Complications of Diabetes: What’s Relevant for Practice?

Biochemical changes in diabetic retinopathy triggered by hyperglycaemia: A review

Background: Diabetes mellitus (DM) is now a global health problem which will lead to increasing incidence of macrovascular and microvascular complications that contribute to morbidity, mortality and premature deaths. Diabetic retinopathy (DR) is a serious complication of DM, and its prevalence is increasing worldwide. Diabetes mellitus is one of the fastest growing causes of visual impairment and blindness in the working-age population.Aim: The aim of this paper was to introduce the multiple interconnecting biochemical pathways that have been proposed and tested as key contributors in how the diabetic eye loses vision.Method: An extensive literature search was performed using the Medline database from 1970 to present. The search subjects included diabetes and eye, diabetic retinopathy and diabetic complications in the eye. The search was limited to the literature pertaining to humans and to English language. Preference was given to recent published papers.Results: Results were limited to human participants with publications in English. References of all included papers were also scrutinized to identify additional studies. Studies were selected for inclusion in the review if they met the following criteria: subjects with diabetes, pathophysiology of diabetic retinopathy.Conclusion: Although the biochemical pathways involved in DR have been researched, to date the exact mechanism involved in the onset and progression of the disease is uncertain, which makes therapeutic interventions challenging. The aim of this review is to discuss the possible biochemical pathways and clinical and anatomical changes that occur during the onset and progression of DR that link hyperglycaemia with retinal tissue damage. An understanding of the biochemical and molecular changes may lead to health care practitioners advising patients with DR on events that lead to possible complications of the diseases.