Cardiovascular Diseases ; epidemiology ; etiology ; China ; epidemiology ; Diabetes Complications ; complications ; epidemiology ; Diabetic Foot ; epidemiology ; etiology ; Diabetic Nephropathies ; epidemiology ; etiology ; Diabetic Neuropathies ; epidemiology ; etiology ; Diabetic Retinopathy ; epidemiology ; etiology ; Humans

OBJECTIVETo explore the relationship between the classification and degree of diabetic macular edema (DME) and the stages of diabetic retinopathy (DR), diabetic duration, classification of diabetes, use of insulin, and visual loss.

METHODSWe retrospectively analyzed the stages of DR, diabetic duration, classification of diabetes, use of insulin, and visual loss in 1 172 DR patients with fundus fluorescein angiography (FFA). The occurrence of DME in DR in each stage and the relationships between its related factors were analyzed.

RESULTSIn 1 172 patients, 633 eyes in 394 patients had DME (33.62%), including 265 (41.86%) with focal DME and 368 (58.14%) with diffuse DME. There were 246 (38.86%) eyes with mild DME, 189 (29.86%) with moderate DME, and 198 (31.28%) with severe DME. Significant correlations exhisted among the classification of DME (r = 0.975, P = 0.025), the degree of DME (r = 1.000, P = 0.000), and the stage of DR. DME deteriorated with the increase of the stages of DR. The visual loss significantly correlated with the degree of DME (r = -0.984, P = 0.003). The visual acuity was lower in patients with diffuse DME than those with focal DME. The diabetic duration significantly correlated with the classification and degree of DME (r = 0.962, P = 0.009). DME was mostly seen in patients with a disease course of six years or longer, and its severity and incidence increased along with the prolonged period. Also, The incidence of DME increased in patients with type 2 diabetes and patients who used insulin.

CONCLUSIONThe classification and degree of DME correlates with the stages of DR, diabetic duration, the classification of diabetes, the use of insulin, and visual loss.

Diabetic Retinopathy ; classification ; complications ; epidemiology ; Humans ; Insulin ; therapeutic use ; Macular Edema ; classification ; epidemiology ; etiology ; Retrospective Studies ; Vision Disorders ; complications ; epidemiology

Over the past decade, significant advances have been made in both the diagnosis and treatment of diabetic retinopathy. Ultrawide field fundus photography and spectral domain optical coherence tomography have allowed more accurate, convenient, and early diagnosis of diabetic retinopathy. Numerous randomized clinical trials have demonstrated the effectiveness of anti-vascular endothelial growth factor agents for the treatment of diabetic retinopathy, although more work is necessary in terms of long-term clinical outcomes and socioeconomic costs associated with these treatments.
Diabetic Retinopathy* ; Diagnosis* ; Early Diagnosis ; Endothelial Growth Factors ; Epidemiology ; Photography ; Tomography, Optical Coherence

Objective: To analyze the effects of community-based interventions for diabetic eye diseases in Xinjing community, Shanghai from 2016 to 2018. Methods: Based on the project of "Establishment of Service Model for Comprehensive Prevention and Treatment of Diabetic Eye Diseases in Shanghai", the participants were not suffering diabetic retinopathy (DR) in Xinjing community in 2016 before interventions and received community-based interventions for diabetic eye diseases. The incidence of DR, visual acuity and awareness of DR were used as evaluation indicators to analyze the effects of interventions for diabetic eye diseases in the community. Results: A total of 537 patients were included in this study, the incidence of DR among diabetic patients in Xinjing community was 7.6% after interventions. The duration of diabetes (OR= 1.065) and HbA1c (OR= 1.090) were the risk factors of DR. Before and after the interventions, the patients with monocular low vision and binocular low vision were 27 cases (5.0%), 8 cases (1.5%), 19 cases (3.5%) and 7 cases (1.3%) respectively. After interventions, the awareness on the prevention and treatment of DR increased significantly, and the proportion of regular visits to ophthalmology examination, diet control and physical exercise also increased significantly. Conclusion: Community-based interventions for diabetic eye diseases are helpful to improve the awareness of DR prevention and control, reduce the incidence of DR.
China/epidemiology* ; Cross-Sectional Studies ; Diabetes Mellitus ; Diabetic Retinopathy/prevention & control* ; Exercise ; Humans ; Risk Factors

OBJECTIVETo investigate the types of lipid disorder and its relationship with macrovascular diseases and insulin resistance in Chinese diabetic patients.

METHODS2,430 diabetic patients finished the diabetes complications assessment and were surveyed on their blood lipids, insulin level and macrovascular diseases. The insulin resistance (HOMA-IR) was calculated based on HOMA model.

RESULTSPrevalence of lipids disorder was as high as 63.8% in this group, including 23.9% with both hypercholesterolemia and hypertriglyceridemia (HY-C-T), 16.1% with hypercholesterolemia only (HY-C), 15.0% with hypertriglyceridemia only (HY-T), 5.5% with lower HDL level (L-HDL), 3.3% with hypercholesterolemia, hypertriglyceridemia and lower HDL level together. Compared with the patients with normal lipid level (control group), no duration differences existed among these groups. There were more female patients in HY-C and HY-C-T groups. BMI and WHR were higher in all groups with lipid disorder except in HY-C group. Macrovascular diseases were more common in HY-C-T patients than in control group (33.6% vs 24.0%, P < 0.001). Average blood pressure and the prevalence of hypertension were significantly higher in HY-C-T, HY-C, HY-T groups than in control group (139/79, 138/76, 134/77 vs. 132/75 mmHg; 53.2%, 50.1%, 46.2% vs. 39.2%). Fasting insulin level was significantly higher in HY-C-T and HY-C-T-L-LDL groups than in controls. Insulin resistance was more severe in all patients with lipid disorder except in L-HDL group, particularly in the HY-C-T-L-HDL group.

CONCLUSIONS(1) BMI, WHR increased significantly with the severity of lipid disorder. (2) Nearly two thirds of Chinese diabetic patients have lipid disorder, which is the strong risk factor of macrovascular diseases and aggravates insulin resistance. (3) There was severe insulin resistance in patients with hypertriglyceridemia or with hypertriglyceridemia plus other lipid disorder.

Adult ; Aged ; China ; epidemiology ; Diabetes Complications ; Diabetic Nephropathies ; etiology ; Diabetic Retinopathy ; etiology ; Female ; Humans ; Hyperlipidemias ; epidemiology ; etiology ; Hypertension ; epidemiology ; etiology ; Insulin Resistance ; Male ; Middle Aged ; Prevalence

INTRODUCTIONThe aim of the study was to describe the prevalence and risk factors for diabetic retinopathy in a multi-ethnic diabetic patient cohort referred for retinal evaluation from a nationwide diabetic retinopathy screening programme in Singapore.

MATERIALS AND METHODSSeven hundred and forty-two patients, aged 21 to 95, referred for suspected diabetic retinopathy on annual one-field non-mydriatic 45 degree retinal photographs (Topcon TRC-NW6, Topcon Corporation, Tokyo, Japan) from primary care to the Singapore National Eye Centre diabetic retinopathy clinic were included. The photographs had been interpreted by 24 trained family physicians accredited every 2 years with a training programme. Patients underwent a standardised interview and examination. Fundi were examined with indirect ophthalmoscopy by 2 examiners. Presence and severity of diabetic retinopathy was graded into none, mild, moderate, severe, very severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. Macular oedema and clinically significant macular oedema were also graded.

RESULTSNinety-nine per cent of patients were type 2 diabetics. The prevalence of diabetic retinopathy was 38.1%, visionthreatening retinopathy was 11.8% and macular oedema was 6.9%. There were no racial differences. Significant predictors of any retinopathy were longer duration of diabetes, lower body mass index, being on treatment for hypertension, hypercholesterolaemia and use of diabetic medication. Predictors for vision-threatening retinopathy were younger age, longer duration of diabetes and lower body mass index.

CONCLUSIONSThe use of one-field non-mydriatic 45 degree photography as a screening tool for diabetic retinopathy resulted in a cohort of which 38.1% had diabetic retinopathy. Risk factors for diabetic retinopathy of this cohort are also presented.

Adult ; Aged ; Diabetic Retinopathy ; diagnosis ; epidemiology ; ethnology ; Female ; Humans ; Male ; Mass Screening ; Middle Aged ; Referral and Consultation ; Singapore ; epidemiology

Diabetic Retinopathy ; complications ; epidemiology ; physiopathology ; Humans ; Neurodegenerative Diseases ; epidemiology ; etiology ; physiopathology ; Retinal Ganglion Cells ; pathology ; Risk Factors

For the past several decades, tremendous efforts have been made to decrease the complications of diabetes, including diabetic retinopathy. New diagnostic modalities like ultrawide field fundus fluorescein angiography and spectral domain optical coherence tomography has allowed more accurate diagnosis of early diabetic retinopathy and diabetic macular edema. Antivascular endothelial growth factors are now extensively used to treat diabetic retinopathy and macular edema with promising results. There remains uncertainty over the long term effects and the socioeconomic costs of these agents.
Diabetic Retinopathy* ; Diagnosis ; Endothelial Growth Factors ; Epidemiology ; Fluorescein Angiography ; Macular Edema ; Tomography, Optical Coherence ; Uncertainty ; Vascular Endothelial Growth Factor A

OBJECTIVETo examine the prognosis of preretinal hemorrhage following vitrectomy and silicone oil tamponade for severe proliferative diabetic retinopathy.

METHODSClinical data of 76 cases of proliferative diabetic retinopathy treated with vitrectomy and silicone oil infusion tamponade in Sir Run Run Shaw Hospital from October 2006 to September 2013 were retrospectively reviewed. Intraoperative bleeding,postoperative preretinal bleeding,blood reabsorption time, and preretinal fibrosis were assessed.

RESULTSAll preretinal hemorrhage developed within 1 week after surgery, blood was distributed in thin and scattered patterns (32 cases), thick and localized patterns (25 cases) or thick and scattered patterns (19 cases). The preretinal hemorrhage was ceased in 1 day after operation in 35 cases, in 2 days after operation in 18 cases, in two weeks after operation in 23 case. Recurrent hemorrhage occurred within 1 week after operation in 15 cases. Thin blood was largely reabsorbed in about two weeks, and thick blood was largely reabsorbed in about five weeks. Fibrosis tissue was resulted in 15 cases(34.1%) with thick blood.

CONCLUSIONMost of preretinal hemorrhage occurs within 1 week after surgery and is reabsorpted with 5 weeks in patients with proliferative diabetic retinopathy undergoing vitrectomy and silicone oil tamponade. The major complication of preretinal bleeding is the formation of preretinal fibrosis.

Diabetic Retinopathy ; surgery ; Fibrosis ; Humans ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Silicone Oils ; therapeutic use ; Vitrectomy ; Vitreous Hemorrhage ; epidemiology

OBJECTIVETo provide an epidemiological description and risk factors of chronic vascular complications of type 2 diabetic in-patients in four municipalities including Beijing, Shanghai, Tianjin, and Chongqing.

METHODSData of the study came from 3,469 Type 2 diabetic in-patients from 1991 to 2000 in 10 medical centers of Beijing, Shanghai, Tianjin, and Chongqing. A variety of parameters of in-patients were evaluated retrospectively to know the prevalence and risk factors of chronic vascular complications in the study patients.

RESULTSOverall, the detailed prevalence of chronic vascular complications is listed as follows: diabetic retinopathy 31.5%, diabetic nephropathy 39.7%, diabetic neuropathy 51.1%, hypertension 41.8%, coronary heart disease (CHD) 25.1%, cerebral vascular disease (CVD) 17.3%, vessel complication of lower limbs 9.3%. Multivariate logistic regression analysis shows that diabetes family history, duration of diabetes (> 5 years), and systolic blood pressure (> 125 mmHg) are the risk factors for diabetic retinopathy; duration of diabetes (> 5 years), systolic blood pressure (> 125 mmHg), LDL-C (> 3.12 mmol/L), and triglyceride (> 1.70 mmol/L) are the risk factors for diabetic nephropathy; age (> 45 years), duration of diabetes (> 5 years), HbA1C (> 7.0%), systolic blood pressure (> 125 mmHg), and LDL-C (> 3.12 mmol/L), are the risk factors for CHD; age (> 45 years), duration of diabetes (> 5 years), systolic blood pressure (> 125 mmHg), and triglyceride (> 1.70 mmol/L) are the risk factors for CVD.

CONCLUSIONIn order to improve patients' outcome, multiple metabolic controls in type 2 diabetic patients are urgently needed, which include decreasing glycemia, reducing hypertension and improving lipid levels.

China ; epidemiology ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Nephropathies ; epidemiology ; etiology ; Diabetic Retinopathy ; epidemiology ; etiology ; Female ; Humans ; Hyperlipidemias ; epidemiology ; etiology ; Hypertension ; epidemiology ; etiology ; Insulin Resistance ; Logistic Models ; Male ; Prevalence ; Retrospective Studies