AN ANALYTICAL STUDY TO EVALUATE SEVERITY OF DIABETIC RETINOPATHY AND INCIDENCE OF NEUROPATHY, NEPHROPATHY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

BACKGROUND Diabetes mellitus is one of the major health problems that have a significant impact on the socioeconomic life of the individual. According to the International Diabetes Federation, 381 million people worldwide suffer due to diabetes. In India, 62 million suffer from diabetes and 1 million die every year due to diabetes. Diabetic patients, during the course of disease, develop microvascular and macrovascular complications. Glycaemic control is of utmost importance in the preventing death due to microvascular and macrovascular complications. The aim of our present study is to analyse the diabetic complications - nephropathy and neuropathy depending on the severity of retinopathy in type 2 diabetic patients. MATERIALS AND METHODS An analytical study conducted among 100 type 2 DM patients who attended the outpatient department and as inpatients admitted to the wards of the Department of Ophthalmology, Government Rajaji Hospital, Madurai, and who satisfied the eligibility criteria for over a period of 5 months. Assessment of diabetic retinopathy was done as per Early Treatment of Diabetic Retinopathy Study (ETDRS) classification. Diabetic Nephropathy was assessed by albuminuria, serum creatinine and blood urea. Diabetic Neuropathy was assessed by Neuropathy Disability Score which includes Vibration perception test, Temperature perception test, Pinprick test, Ankle jerk. Analysis of nephropathy and neuropathy was done depending on severity of Retinopathy in type 2 diabetic patients. Observation-Patients with mild NPDR showed 100% subclinical albuminuria, patients with moderate NPDR showed 97.6% microalbuminuria and 2.4% showed macroalbuminuria and in those patients with severe NPDR, very severe NPDR, early PDR, highrisk PDR and diabetic maculopathy, showed 100% macroalbuminuria. Lower limb assessment for diabetic neuropathy, showed neuropathy in 29% cases. RESULTS Diabetic retinopathy has a significant association with blood urea and serum creatinine with significant 'p' value of 0.0001. Neuropathy was 100% absent in mild and moderate NPDR and 100% present in severe NPDR, very severe NPDR, early PDR, highrisk PDR and diabetic maculopathy. CONCLUSION Among patients presented in our study, the severity of diabetic retinopathy correlates well with significant incidence and severity of nephropathy and peripheral neuropathy.