A Delayed Diagnosis in Type 2 Diabetes: Retinopathy

ABSTRACT
Diabetic retinopathy is the leading cause of blindness in the 20-74 years old age group in developed countries. Aim of this retrospective study was to evaluate the incidence of diabetic retinopathy (DR) and the general characteristics of the patients in their first admittance to the Şişli Etfal Hospital Diabetes Center. A group of 1181 patients diagnosed as type 2 diabetes mellitus according to the WHO criteria admitting to Şişli Etfal Hospital Diabetes Center for the first time in years 2000 or 2001 were studied retrospectively. Retinal examination was performed on all patients by the ophthalmology clinic in the first admittance and was repeated annually. Diabetic retinopathy was diagnosed in 268 (22.69%) of the 1181 retrospectively studied patients. 151 (56.00%) of these cases were evaluated as background DR (mild-moderate nonproliferative), 61 (23.11%) as preproliferative DR (moderate-advanced nonproliferative) and 56 (20.89%) as proliferative DR. in the retinopathic patient group, mean value for age was 59.11±11.46 years, HbA1c 9.31±2.30%, fasting blood glucose 219.49±87.04 mg/dL, duration of diabetes 10.20±7.59 years, age of onset of diabetes 49.02±12.19 years. Microalbuminuria was detected in 150 of the 268 cases and >30 mg/day microalbuminuria was reported in 80 patients. Mean amount of microalbuminuria in these 80 patients was 263.97±67.9 mg/day. Risk factors known to be responsible for the development of DR such as chronic hyperglycemia, accompanying hypertension, dyslipidemia, diabetic nephropathy and diabetes duration was observed by the evaluation of the general characteristics of the patient group. A DR rate of 23% at first admission suggests that the health care personnel as well as the patient population are ignorant about the management of diabetes mellitus and its complications.