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Title: Diabetic retinopathy in diabetic patients versus diabetic with co-morbid hypertensive patients.
Authors: Mohammad Alam
Journal: The Professional Medical Journal (TPMJ)
Publisher: Independent Medical College, Faisalabad- Pakistan
Country: Pakistan
Year: 2022
Volume: 29
Issue: 7
Language: English
DOI: 10.29309/TPMJ/2022.29.07.6861
Keywords: Diabetes mellitus (DM)Diabetic Retinopathy (DR)Non-proliferative Diabetic Retinopathy (NPDR)Proliferative Diabetic Retinopathy (PDR)
Objectives: To find out severity of diabetic retinopathy in diabetic versus diabetic with co-morbid hypertensive patients in type II diabetes mellitus. Study Design: Comparative study. Setting: KDA Teaching Hospital Kohat. Period: March 2017 to December 2020. Material & Methods: This comparative study focused on severity of diabetic retinopathy was conducted on only type II diabetic patients versus type II diabetic with co-morbid hypertensive patients. Two groups A for diabetic and B for diabetic with co-morbid hypertension patients were made. Proper proforma of diabetic age and severity of diabetic retinopathy was designed for record. First 200 patients with only diabetes mellitus comprising of 123(61.5%) male and 77(38.5%) female were registered in group A and first 200 diabetic patients with co-morbid hypertension comprising of 97(48.5%) male and 103(51.5%) female were registered in group B. Proper informed consents obtained from all patients. Both A and B groups were subdivided into A 1 with diabetic age upto 10 years had 105(52.5%) patients, A 2 with diabetic age 11-20 years had 60(30%) patients, A 3 with diabetic age > 20 years had 35(17.5%) patients and B 1 with diabetic age upto 10 years had 117(58.5%) patients, B2 with diabetic age 11-20 years had 55(27.5%) patients and B3 with diabetic age >20 years had 28(14%) patients. Results: Group A. A 1 had 9(8.57%) patients with non-proliferative diabetic retinopathy. A 2 had 13(21.66%) with non-proliferative and 4(6.66) % with proliferative diabetic retinopathy patients. A 3 had 15 (42.85%) non-proliferative and 16(45.71%) proliferative diabetic retinopathy patients. Group B. B 1 had 14(11.96%) patients with non-proliferative diabetic retinopathy. B 2 had 16(29.09%) with non-proliferative and 10(18.18%) with proliferative diabetic retinopathy patients. B 3 had 12(42.85%) non-proliferative and 14(50)% proliferative diabetic retinopathy patients. Conclusion: Diabetic retinopathy is adversely affected by co-morbid hypertension.
To determine the severity of diabetic retinopathy in type II diabetic patients compared to type II diabetic patients with co-morbid hypertension.
A comparative study was conducted on type II diabetic patients and type II diabetic patients with co-morbid hypertension. Two groups were formed: Group A (diabetic patients) and Group B (diabetic patients with co-morbid hypertension). Each group consisted of 200 patients. Patients were further subdivided based on diabetic age (up to 10 years, 11-20 years, and >20 years). Diabetic retinopathy severity was assessed through fundus examination using an indirect ophthalmoscope and slit lamp indirect bimicroscopy.
graph TD;
A[Recruit Type II Diabetic Patients] --> B[Divide into Groups];
B --> C[Group A: Diabetic Patients];
B --> D[Group B: Diabetic Patients with Hypertension];
C --> E[Subdivide Group A by Diabetic Age];
D --> F[Subdivide Group B by Diabetic Age];
E --> G[Assess DR Severity for Group A Subgroups];
F --> H[Assess DR Severity for Group B Subgroups];
G --> I[Analyze Results for Group A];
H --> J[Analyze Results for Group B];
I --> K[Compare DR Severity between Groups];
J --> K;
K --> L[Draw Conclusions];
The severity of diabetic retinopathy is directly proportional to diabetic age and is accelerated by co-morbid hypertension. Patients with hypertension alongside diabetes exhibit more progressive and severe retinopathy. The findings suggest that controlling hypertension is crucial for preventing the worsening of diabetic retinopathy.
In Group A (diabetic patients), the prevalence of proliferative diabetic retinopathy (PDR) increased with diabetic age, from 0% in A1 (up to 10 years) to 6.66% in A2 (11-20 years) and 45.71% in A3 (>20 years). In Group B (diabetic patients with co-morbid hypertension), the prevalence of PDR also increased with diabetic age, from 0% in B1 (up to 10 years) to 18.18% in B2 (11-20 years) and 50% in B3 (>20 years). The study observed a higher severity of diabetic retinopathy, particularly PDR, in diabetic patients with co-morbid hypertension compared to those without hypertension, especially in older diabetic age groups.
Diabetic retinopathy is a serious ocular complication whose severity is influenced by diabetic age and glycemic control. Co-morbid hypertension exacerbates the severity of diabetic retinopathy. Regular screening for diabetic retinopathy is recommended for all diabetic patients after 6 years of diabetic age, with concurrent hypertension requiring proper management.
1. Study Period: The study was conducted from March 2017 to December 2020. (Confirmed in the text).
2. Group Size: Each of the two main groups (diabetic and diabetic with hypertension) comprised 200 patients. (Confirmed in the text).
3. PDR in Group B3: In Group B3 (diabetic patients with co-morbid hypertension and diabetic age > 20 years), 50% of patients had proliferative diabetic retinopathy. (Confirmed in Table-V).
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