The Dynamics of the Prevalence and Risk of Diabetic Retinopathy in Patients with Diabetes Mellitus
Questions of active detection and timely treatment of complications of diabetes mellitus (DM) in the early stages remain relevant.
The objective of the investigation was to study the dynamics of the prevalence of diabetic retinopathy (DR) in adult patients with DM, given the type and duration of disease, age and sex of patients, their place of residence, the degree of compensation of carbohydrate metabolism, as well as in the evaluation of the absolute and relative risk of DR.
Materials and Methods. In the 13 rural districts and five cities of regional subordination of Transcarpathian region in 2009 there has been surveyed a random sample of patients with DM type 1 and type 2 (2103 people) aged over 18 years. In the second phase of the study (2012) the re-examination (rescrining) a random sample of patients with DM type 1 and type 2 (1947 patients) has been carried out.
Results. The frequency of DR is 54.5 %, including among patients with DM type 1 — 63.1 %, DM type 2 — 48.6 %. The prevalence of macrovascular complications in patients with DR was significantly higher in DM type 1, compared with the group of patients without DR. The presence of DR in patients with DM type 1 determines the high relative risk of developing diabetic foot syndrome, diabetic distal polyneuropathy, diabetic cataract, myocardial infarction. The highest absolute and relative risk of DR was associated with duration of DM of more than 5 years, HbA1c level greater than 7.5 %, the presence of diabetic nephropathy and hypertension.
Conclusions: prevalence of all stages of DR is significantly higher in DM type 1 than in DM type 2 and increases with the duration of DM, reaching a maximum in the presence of DM type 1 for over 20 years and 67.4 % in DM type 2 for 15–20 years. In the study of the risk of DR in adult patients with DM a statistically significant positive correlation of DR was obtained with DM duration, age of the patients, the levels of HbA1c, systolic and diastolic blood pressure, the presence of microalbuminuria.
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