A Retrospective Analysis for Progression to Proliferative Diabetic Retinopathy (PDR) in Type 2 Diabetes

Abstract

Purpose: : The United Kingdom Prospective Diabetes Study (UKPDS) established intensive control of blood glucose and blood pressure slowed progression of retinopathy and reduced microvascular complications in Type 2 Diabetes. We hypothesize specific characteristics could be established that risk stratify patients with Type 2 Diabetes as to the progression of diabetic retinopathy.

Methods: : We compared duration of illness, Hba1c, and insulin dependence between 52 consecutive patients with Type 2 Diabetes with Proliferative Diabetic Retinopathy (PDR) who received Pan Retinal Photocoagulation (PRP) to a control of 52 patients with Type 2 Diabetes in a general medical practice.

Results: : Patients with Type 2 Diabetes and PDR had a 76.9% likelihood of insulin-dependence verses 17.3% (p<0.001 by chi square test), a median HbA1c of 9.5% verses 7.6% (p=0.0005 by the Mann-Whitney test), and had diabetes for a median of 10 years verses 4 years (p<0.0001 by the Mann-Whitney test).

Conclusions: : Results indicate that in our population, Proliferative Diabetic Retinopathy (PDR) is significantly associated with longer duration of illness, insulin dependence and an elevated HbA1c. Insulin dependence in clinical practice may indicate poor diabetic control or progression of disease as opposed to intensive blood glucose control and patients should be examined closely for signs of high-risk Proliferative Diabetic Retinopathy at regular intervals.

Keywords: diabetic retinopathy • diabetes • clinical (human) or epidemiologic studies: risk factor assessment