Endocrine Abstracts

Background: Micro and macroangiopathy are two major complications of diabetes. Diabetic retinopathy (DR) and nephropathy (ND) which represented microangiopathy, are present early in type 2 diabetes. Macroangiopathy represented by atherosclerotic process assessed through intima-media thickness (IMT) of carotid artery. Microalbuminuria (MI) predictor of ND is associated with DR in type II diabetic patients and is a reliable marker of DR. The aim was to search for association between DR and IMT and to identify risk factors for the development of DR and MI and their correlation.

Materials and methods: Of 65 patients, 22 men and 43 women with mean age 58.6±10.09, with type 2 diabetes, for at least 5 years, were examined at the Department of Internal Medicine. The ocular fundi were examined by a specialist, by direct ophthalmoscope and common carotid artery IMT was measured by a B-mode ultrasound, 10 MHz transducer. These patients were evaluated for presence of MI (a urinary albumin excretion between 30 and 300 mg/l per day), body mass index (BMI) and glycosylated hemoglobin (HbA1C).

Results: DR was found in 25(38.5%) diabetic patients. IMT was higher in patients with DR than in patients without DR (0.91 mm vs 0.82 mm, P=0.001, respectively).

The relationship between DR and risk factors such as HbA1C, BMI, duration of illness and age revealed to be significant. HbA1C was higher in patients with DR (mean =10.5%) than in patients with no signs of retinopathy (mean=9.5%) and this difference was statistically significant (P=0.001). As expected, DR and renal involvement were highly positively correlated. (P=0.001).

Conclusion: DR is associated with increased IMT. Elevated HbA1C predicts DR.

Retinopathy is associated cross sectionaly with the presence of MI in persons with diabetes type 2. So, diabetic patients with DR need particularly intensive cardiovascular screening.