General health of patients with diabetic macular edema—The LIPSIA study

Abstract

Purpose Cardiovascular risk factors such as hypertension or dyslipidemia can influence the incidence and progression of diabetic retinopathy (DR) and diabetic macular edema (DME). The aim of this study is to describe the comorbidities in patients with DME. Methods Prospective, monocentric observational study. Patients presenting for the treatment of DME received laboratory and clinical examinations including 24-hour blood pressure measurement. Results Seventy-five consecutive patients were included in the study. The mean age was 61.0 ± 14.5 years, and 83% had type 2 diabetes. The mean body mass index (BMI) was 32.8 ± 6.0 kg/m2. Overweight (BMI ≥ 25 kg/m2) was present in 92% of all patients. HbA1c values were > 7.0% in 57%. Although 87% of the patients already received antihypertensive therapy, the blood pressure (BP) of 82% was still above the recommended target values of systolic < 140 mmHg and diastolic < 80 mmHg. An insufficient nocturnal fall of the systolic BP (< 10%, non-dipping or reverse dipping) was observed in 62%. In 83% of the patients the glomerular filtration rate was ≤ 90 ml/min/1.73m2. Despite 65% of the cohort already receiving lipid-lowering therapy, LDL cholesterol was above the target value of 1.4 mmol/l in 93%. All patients had at least one cardiovascular risk factor in addition to diabetes (overweight, hypertension, insufficient nocturnal BP fall, dyslipidemia, or renal dysfunction) and 86% had ≥ 3 risk factors. Conclusion DME patients are characterized by highly prevalent cardiovascular risk factors that are poorly controlled. These comorbidities reduce the prognosis and negatively influence existing DR and DME. The data reveal an important opportunity for improving patient care by interaction of the ophthalmologist with the general practitioner and internal specialists for the detection and treatment of these conditions.

Correlation between the Outcome of Vitrectomy for Proliferative Diabetic Retinopathy and Erythrocyte Hematocrit Level and Platelet Function

“…Contrary to expectations, the group with high diastolic blood pressure in the present study did not require treatment ( p = 0.03). High diastolic blood pressure is a risk factor for DR, heart disease, and CVD [ 35 , 36 ]. It was also reported to be a risk factor for DME [ 36 , 37 ].…”

“…High diastolic blood pressure is a risk factor for DR, heart disease, and CVD [ 35 , 36 ]. It was also reported to be a risk factor for DME [ 36 , 37 ]. Further studies with larger sample sizes will be necessary to determine the role of HT in PDR.…”

Особливості Розвитку Діабетичного Макулярного Набряку І Різних Стадій Діабетичної Ретинопатії При цукровому Діабеті 2-Го Типу

“…Серед загальноклінічних показників більшою мірою були пов'язані с розвитком ДМН такі параметри перебігу ЦД, як глікемія, артеріальний тиск і вміст у крові ліпідів [22]. Крім того, пацієнти з ДМН характеризувалися значною поширеністю серцево-судинних факторів ризику, які погано контролюються.…”

“…Крім того, пацієнти з ДМН характеризувалися значною поширеністю серцево-судинних факторів ризику, які погано контролюються. Ці супутні захворювання погіршують прогноз і негативно впливають на наявні ДР і ДМН [22]. За нашими даними, вміст у крові глюкози й глікованого гемоглобіну з ризиком ДМН пов'язаний не був.…”