Pristine Diagnosis And Prevention Correlation Factors Of Diabetic Retinopathy

Object To explore the pristine diagnosis and prevention correlation factors of diabetic retinopathy (DR) in type 2 diabetes and to provide reliable evidence for clinical prevention,diagnosis and cure.Methods The clinical data of 412 patients, with type 2 diabetes diagnosed in the third affiliated hospital of Guangzhou medical college from 2004 to 2010 were analyed retrospectively. The diagnosis of DR and proliferative diabetic retinopathy (PDR) was confirmed by fundoscopy and fluorescein angiography. hemoglobin A1c ;fasting plasma glucose,insulin and C-peptide;1 hour,2 hour and 3 hour postprandial plasma glucose, insulin and C-peptide were measured. According to the above-mentioned data,get 1 hour,2 hour and 3 hour postprandial plasma glucose,insulin and C-peptide fluctuation.Results①Of the 412 cases, 205 of them (49.76%) had type 2 diabetes without diabetic retinopathy , 154 of them (37.38%) had non-proliferative diabetic retinopathy(NPDR),53 of them (12.86%) had proliferative diabetic retinopathy.②Age, diabetic duration,body mass index (BMI), hypertension grade, hemoglobin A1c, fasting plasma insulin and C-peptide, 2 hour and 3 hour postprandial plasma glucose, 1 hour,2 hour postprandial plasma insulin, 1 hour,2 hour and 3 hour postprandial plasma C-peptide, 1 hour,2 hour and 3 hour postprandial plasma glucose, insulin and C-peptide fluctuation are different in statistics among non-DR group,NPDR group and PDR group. Fasting plasma glucose,1 hour postprandial plasma glucose and 3 hour postprandial plasma insulin are not different among the three groups.③The morbidity of DR and PDR increased following the longer diabetic duration.④The spearman rank association test between the happen of diabetic retinopathy and variables correlated with glucose ,insulin and C-peptide shows,except for fasting plasma glucose,1 hour postprandial plasma glucose, 1 hour postprandial plasma glucose fluctuation and 3 hour postprandial plasma insulin(P>0.05),P<0.05.⑤3 hour postprandial plasma glucose and fasting plasma insulin were risk factors of DR,the exp(B) was 1.190 and 1.064.⑥0.275,0.335,0.344 were the correlation coefficients of the spearman rank association test between hemoglobin A1c and Fasting plasma glucose,2 hour,3 hour postprandial plasma glucose respectively.conclusions①Higher postprandial plasma glucose and fasting plasma insulin were risk factors of DR,in clinical work, it is quite important to measure postprandial plasma glucose and fasting plasma insulin for inchoate prevention of DR.②Lower postprandial insulin ,lower fasting and postprandial C-peptide were useful for DR inchoate diagnosis.③Higher postprandial plasma glucose fluctuation , lower postprandial insulin and C-peptide fluctuation were also helpful to diagnose DR early.