Early diagnosis diabetic retinopathy / Монголын Анагаах Ухаан

ABSTRACT

IntroductionThere are an estimated 246 million people with diabetes mellitus globally and this figure is predictedto rise to 380 million by 2025, with the most rapid growth in developing countries, among the workingage group of the population.Now in Mongolia, the more than half of population live in cities and settlements, following thisurbanization the population`s diet and lifestyle has been changed to more western style and morepeople affected by diabetes mellitus.Diabetic retinopathy is the most common chronic and devastating complication of diabetes whichleads to visual impairment and blindness. Diabetic retinopathy develops in nearly all persons withtype 1 diabetes and in more than 77% those with type 2 who survive over 20 years with disease. Thecurrent estimates of the prevalence of diabetic retinopathy vary in different countries. The WHO hasestimated that diabetic retinopathy is responsible for 4.8% of 37 million cases of blindness throughoutthe world.Significant independent predictors of proliferative diabetic retinopathy determined by multivariableanalysis were fasting plasma glucose level, duration diabetes, plasma cholesterol, systolic bloodpressure and therapeutic regimen.In recent years a number of randomized clinical trials have shown that interventions to improvemetabolic control, careful monitoring and treatment reduce late diabetic complications.GoalTo establish the prevalence, severity and risk factors of diabetic retinopathy type 2 diabetic patientsin Ulaanbaatar.Materials and MethodsThe study conducted by cross sectional study. Randomly selected 235 patients type 2 diabetic patientsfrom Bayanzurh districts of city Ulaanbaatar. Participants provided a detailed medical and personalhistory, underwent an ocular examination including funduscopy. Fasting blood glucose-FBG, totalcholesterols, triglyceride, HDL were determined by methods of laboratory in venous plasma.ResultsThe prevalence of diabetic retinopathy among people with type 2 diabetes was 37.4%. The prevalencenon-proliferative diabetic retinopathy was 17% (40), pre-proliferative diabetic retinopathy was 8.1%(19), and of proliferative diabetic retinopathy was 12.3 %( 29).The mean age of participants with diabetic retinopathy was 57.4 years (range 26-79). The meanage of participants with non-diabetic retinopathy was 53.6 years (range 26-76). The prevalence of diabetic retinopathy did not vary significantly with age. Retinopathy was positively associated with alonger reported duration of diabetes and with higher fractions of blood glucose (p<0.05).Progression of diabetic retinopathy positively associated with high level fasting blood glucose (6.2mmol/l), total cholesterol (4.5 mmol/l), systolic pressure (130 mm Hg) diastolic pressure (90 mm Hg),triglyceride (2.2 mmol.l) and low level HDL (1.1 mmol/l).ConclusionRisk factors for diabetic retinopathy were found to be high level of blood glucose, longer duration ofdiabetes. Diabetes poor control was significantly associated with progression of diabetic retinopathy.