Cent Eur J Public Health 2023, 31(Suppl 1):S4-S9 | DOI: 10.21101/cejph.a7838

Diabetes mellitus and its influence on the incidence and process of diabetic retinopathy

Janka Poráčová1, Melinda Nagy2, Marta Mydlárová Blaščáková1, Mária Konečná1, Vincent Sedlák1, Mária Zahatňanská3, Tatiana Kimáková4, Hedviga Vašková1, Viktória Rybárová1, Mária Majherová5, Ivan Uher6
1 Department of Biology, Faculty of Humanities and Natural Sciences, University of Prešov, Prešov, Slovak Republic
2 Department of Biology, Faculty of Education, J. Selye University, Komárno, Slovak Republic
3 Institute of Pedagogy, Andragogy and Psychology, Faculty of Humanities and Natural Sciences, University of Prešov, Prešov, Slovak Republic
4 Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Šafárik University, Košice, Slovak Republic
5 Department of Physics, Mathematics and Technologies, Faculty of Humanities and Natural Sciences, University of Prešov, Prešov, Slovak Republic
6 Institute of Physical Education and Sports, Pavol Jozef Šafárik University, Košice, Slovak Republic

Objectives: The main aim of the study was to show the effect of diabetes in relation to the gender of the patients, duration of the disease, and on the incidence of diabetic retinopathy. In this study, we investigated the prevalence of these two diseases, pathological ocular changes and progression of disease occurrence in relation to the duration of the disease with respect to their impact on the quality of vision of the patient.

Methods: The prospective observational cross-sectional study included 3,951 patients (1,838 males, 2,113 females) with diabetes mellitus from 7 districts of eastern Slovakia. Patients with diabetes mellitus and diabetic retinopathy were identified by special screening in the number of 2,093 (1,094 females and 999 males). Subjects were divided by sex and by duration of diabetes into 5 groups: patients with diabetes under 5, 10, 15, 20, and over 20 years. We differentiated between proliferative and non-proliferative forms of diabetic retinopathy and monitored changes in visual quality. Manifestations of pathological changes were recorded using special examination methods in the eye clinic. We observed a decrease in vision by two lines, pathological changes on the retina and the occurrence of practical blindness.

Results: Of the total number of diabetic patients examined, diabetic retinopathy was also present in more than half of the patients. The major form represented in the patients was the non-proliferative form of retinopathy. The obtained results confirmed that the representation of patients with diabetic retinopathy increases with increasing duration of diabetes. Similarly, pathological changes characteristic of this type of late complication of diabetes were also more frequent, such as deterioration of visual acuity, the appearance of aneurysms, hard exudates macular edema, and gradual loss of vision, which can result in practical blindness.

Conclusion: The percentage of people with diabetic retinopathy increases with the duration of diabetes, as well as the increased frequency of pathological late complication of diabetes, including deterioration of visual acuity, the development of aneurysms, hard exudates, macular oedema, and gradual loss of vision, which can result in practical blindness. Early diagnosis of the disease and introduction of appropriate treatment would alleviate the symptoms of the disease in more than half of the patients, so more frequent preventive check-ups with an ophthalmologist should be performed in diabetic patients to avoid detection of the disease in its late stages.

Keywords: diabetes mellitus, diabetic retinopathy, pathological changes of retina, visual acuity, practical blindness

Received: April 12, 2023; Revised: December 4, 2023; Accepted: December 4, 2023; Published: December 31, 2023  Show citation

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Poráčová J, Nagy M, Mydlárová Blaščáková M, Konečná M, Sedlák V, Zahatňanská M, et al.. Diabetes mellitus and its influence on the incidence and process of diabetic retinopathy. Cent Eur J Public Health. 2023;31(Suppl 1):S4-9. doi: 10.21101/cejph.a7838. PubMed PMID: 38272471.
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References

  1. World Health Organization. Diabetes [Internet]. Geneva: WHO; 2023 [cited 2023 Feb 6]. Available from: https://www.who.int/health-topics/diabetes#tab=tab_1.
  2. Wong TY, Sun J, Kawasaki R, Ruamviboonsuk P, Gupta N, Lansingh VC, et al. Guidelines on diabetic eye care: the International Council of Ophthalmology Recommendations for screening, follow-up, referral, and treatment based on resource settings. Ophthalmology. 2018 Oct 125(10):1608-22. Go to original source... Go to PubMed...
  3. Feldman-Billard S, Larger É, Massin P; Standards for screeningand surveillance of ocular complications in people with diabetes SFD study group. Early worsening of diabetic retinopathy after rapid improvement of blood glucose control in patients with diabetes. Diabetes Metab. 2018 Feb;44(1):4-14. Go to original source... Go to PubMed...
  4. Campochiaro PA, Aiello LP, Rosenfeld PJ. Anti-vascular endothelial growth factor agents in the treatment of retinal disease: from bench to bedside. Ophthalmology. 2016 Oct;123(10S):S78-88. Go to original source... Go to PubMed...
  5. Reddy MA, Zhang E, Natarajan R. Epigenetic mechanisms in diabetic complications and metabolic memory. Diabetologia. 2015 Mar;58(3):443-55. Go to original source... Go to PubMed...
  6. Rübsam A, Parikh S, Fort PE. Role of inflammation in diabetic retinopathy. Int J Mol Sci. 2018 Mar 22;19(4):942. doi: 10.3390/ijms19040942. Go to original source... Go to PubMed...
  7. Wykoff CC. Impact of intravitreal pharmacotherapies including antivascular endothelial growth factor and corticosteroid agents on diabetic retinopathy. Curr Opin Ophthalmol. 2017 May;28(3):213-8. Go to original source... Go to PubMed...
  8. Beszédešová N. Screening for diabetic retinopathy. Intern Med Prax. 2007;9(7):345-8.
  9. Kusuhara S, Fukushima Y, Ogura S, Inoue N, Uemura A. Pathophysiology of diabetic retinopathy: The old and the new. Diabetes Metab J. 2018 Oct;42(5):364-76. Go to original source... Go to PubMed...
  10. Vesely. [Retinal diseases] [Internet]. Košice: Vesely Eye Clinic; 2023 [cited 2023 Feb 28]. Available from: https://veselyok.com/ochorenia-sietnice/. Slovak.
  11. National Health Information Centre. Annual report on the activity of the diabetology outpatient clinic A (MZ SR) 2-01 [Internet]. Bratislava: NCZI; 2021 [cited 2023 Mar 6]. Available from: https://www.nczisk.sk/Statisticke-zistovania/Rocne-vykazy/Rocne-vykazy-za-rok-2021/Pages/default.aspx.
  12. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010 Jan;87(1):4-14. Go to original source... Go to PubMed...
  13. Prokofyeva E, Zrenner E. Epidemiology of major eye diseases leading to blindness in Europe: a literature review. Ophthalmic Res. 2012;47(4):171-88. Go to original source... Go to PubMed...
  14. Nentwich MM, Ulbig MW. Diabetic retinopathy. Der Diabetologe. 2010 Sep;6(6):491-502. Go to original source...
  15. Cherchi S, Gigante A, Spanu MA, Contini P, Meloni G, Fois MA, et al. Sex-gender differences in diabetic retinopathy. Diabetology. 2020;1(1):1-10. Go to original source...
  16. Zhang X, Saaddine JB, Chou CF, Cotch MF, Cheng YJ, Geiss LS, et al. Prevalence of diabetic retinopathy in the United States, 2005-2008. JAMA. 2010 Aug 11;304(6):649-56. Go to original source... Go to PubMed...
  17. Seghieri G, Policardo L, Anichini R, Franconi F, Campesi I, Cherchi S, et al. The Effect of sex and gender on diabetic complications. Curr Diabetes Rev. 2017;13(2):148-60. Go to original source... Go to PubMed...
  18. Solomon SD, Chew E, Duh EJ, Sobrin L, Sun JK, VanderBeek BL, et al. Diabetic retinopathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017;40(3):412-8. Go to original source... Go to PubMed...
  19. Marino M, Masella R, Bulzomi P, Campesi I, Malorni W, Franconi F. Nutrition and human health from a sex-gender perspective. Mol Aspects Med. 2011 Feb;32(1):1-70. Go to original source... Go to PubMed...
  20. Hu G; DECODE Study Group. Gender difference in all-cause and cardiovascular mortality related to hyperglycaemia and newly-diagnosed diabetes. Diabetologia. 2003;46(5):608-17. Go to original source... Go to PubMed...
  21. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes - related complications. Phys Ther. 2008 Nov; 88(11):1254-64. Go to original source... Go to PubMed...
  22. Mazhar K, Varma R, Choudhury F, McKean-Cowdin R, Shtir CJ, Azen SP, Severity of diabetic retinopathy and health-related quality of life: The Los Angeles Latino Eye Study. Ophthalmology. 2011;118(4):649-55. Go to original source... Go to PubMed...
  23. Cunningham-Myrie C, Younger-Coleman N, Tulloch-Reid M, McFarlane S, Francis D, Ferguson T, et al. Diabetes mellitus in Jamaica: sex differences in burden, risk factors, awareness, treatment and control in a developing country. Trop. Med. Int. Health 2013; 18(11):1365-78. Go to original source... Go to PubMed...
  24. Mehlsen J, Erlandsen M, Poulsen PL, Bek T. Identification of independent risk factors for the development of diabetic retinopathy requiring treatment. Acta Ophthalmol. 2011;89(6):515-21. Go to original source... Go to PubMed...
  25. Errera MH, Kohly RP, da Cruz L, Pregnancy-associated retinal diseases and their management. Surv Ophthalmol. 2013 Mar-Apr;58(2):127-42. Go to original source... Go to PubMed...
  26. Negrato CA, Mattar R, Gomes MB. Adverse pregnancy outcomes in women with diabetes. Diabetol Metab Syndr. 2012;4(1):41. doi: 10.1186/1758-5996-4-41. Go to original source... Go to PubMed...
  27. Fong DS, Aiello L, Gardner TW, King GL, Blankenship G, Cavallerano JD, et al.; American Diabetes Association. Retinopathy in diabetes. Diabetes care. 2004 Jan;27 Suppl 1:S84-7. Go to original source... Go to PubMed...
  28. Gelcho GN, Gari FS, Time to diabetic retinopathy and its risk factors among diabetes mellitus patients in Jimma University Medical Center, Jimma, Southwest Ethiopia. Ethiop J Health Sci. 2022;32(5):937-46. Go to original source... Go to PubMed...
  29. Frank RN. Diabetic retinopathy and systemic factors. Middle East Afr. J. Ophthalmol. 2015 Apr-Jun;22(2):151-6. Go to original source... Go to PubMed...
  30. Chisha Y, Terefe W, Assefa H. Incidence and factors associated with diabetic retinopathy among diabetic patients at Arbaminch General Hospital, Gamo Gofa zone (longitudinal follow up data analysis). J Diabetol. 2017;8(1):1-6. Go to original source...
  31. Khan WJ, Aslam T. Frequency of retinopathy in patients newly diagnosed with type 2 diabetes mellitus. Cureus. 2023;15(3):e36513. doi: 10.7759/cureus.36513. Go to original source... Go to PubMed...
  32. Jokhio AH, Talpur KI, Shujaat ST, Talpur BR, Memon S. Prevalence of diabetic retinopathy in rural Pakistan: A population based cross-sectional study. Indian J Ophthalmol.2022;70(12):4364-9. Go to original source... Go to PubMed...