Short communication: Unique metabolic signature of proliferative retinopathy in the tear fluid of diabetic patients with comorbidities – Preliminary data for PPPM validation

Abstract

Type 2 diabetes (T2DM) defined as the adult-onset type that is primarily not insulin-dependent, comprises over 95% of all diabetes mellitus (DM) cases. According to global records, 537 million adults aged 20-79 years are affected by DM; that means 1 out of 15 persons. This number is projected to grow by 51% by the year 2045. One of the most common complications of T2DM is diabetic retinopathy (DR) with an overall prevalence over 30%. With improved screening, the overall part of patients presenting severe vision loss is declining within the DM cohort. Blindness is closely related to proliferative diabetic retinopathy. However, DR is still the leading cause of preventable blindness in working-age adults and the total number of the DR-related visual impairments is on the rise, due to the growing T2DM population. Moreover, PDR with characteristic systemic attributes including mitochondrial impairment, increased cell death and chronic inflammation,is an independent predictor of the cascading DM-complications such as ischemic stroke. Therefore, early DR is a reliable predictor appearing upstream of this “domino effect”. Global screening, leading to timely identification of DM complications, is insufficiently applied by the currently applied reactive medicine as well as lack of resources in certain parts of the world. A personalised predictive approach and cost-effective targeted prevention called PPPM/3P (predictive, preventive and personalised) medicine could make use of the knowledge, preventing blindness and further severe DM complications. In order to reach this goal, reliable biomarkers are needed that are easy to collect and deliver robust data about different stages of DR.