Publication: Association of HBA1c and Plasma Glucose Levels with Diabetic Retinopathy
Date
2025
Authors
Shrestha, P
Chaudhary, A
Shrestha, JK
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Diabetic retinopathy is one of the leading causes of blindness worldwide. The
relationship between glucose level and development of diabetic retinopathy has
always been an area of interest and constantly evolving.
Objective
To determine the association of glycosylated hemoglobin and plasma glucose levels
with different grades of diabetic retinopathy.
Method
A hospital based cross sectional study was conducted among 504 patients with type
II diabetes mellitus attending the Department of Ophthalmology in a University
Hospital for one year duration. Relevant history regarding diabetes mellitus was
recorded for all patients. The status of diabetic retinopathy in each patient was
diagnosed by detailed ophthalmological examination and classified according to
International Classification of Diabetic Retinopathy Scale. All the patients were
evaluated for their glycosylated hemoglobin, fasting and post prandial blood glucose
levels. Bivariate analysis using t-tests and chi-square tests was used to measure the
strength of association between the different variables. An Analysis of Variance
(ANOVA) test was used to evaluate the association between the means of different
variables.
Result
Total 504 patients constituted of 254 males (50.39%) and 250 (49.60 %) females.
Almost half of the study population had poor glycemic control and deranged fasting
and post prandial blood sugar levels. Diabetic retinopathy was observed in 124
(24.60%) patients and diabetic macular edema was observed in 42 (8.33%) patients.
Poor control of glycosylated hemoglobin (> 7.6) was seen in 88 (70.96%) cases of
diabetic retinopathy and 34 (80.95%) cases of diabetic macular edema. Uncontrolled
fasting and postprandial blood sugar levels were associated with a significant
number of cases of diabetic retinopathy and of diabetic macular edema respectively.
A statistically significant association was observed between increasing grades of
diabetic retinopathy and higher glycosylated hemoglobin and plasma glucose levels.
Conclusion
Higher the level of glycosylated hemoglobin and plasma glucose levels, more severe
is the grade of diabetic retinopathy.
KEY WORDS
Diabetic retinopathy (DR), Fasting blood sugar, Glycosylated hemoglobin (HBA1c),
Non-proliferative diabetic retinopathy (NPDR), Proliferative diabetic retinopathy
(PDR)
Description
Shrestha P, Chaudhary A, Shrestha JK
Department of Ophthalmology
Dhulikhel Hospital, Kathmandu University Hospital
Kathmandu University School of Medical Sciences
Dhulikhel, Kavre, Nepal
Keywords
Diabetic retinopathy (DR), Fasting blood sugar, Glycosylated hemoglobin (HBA1c), Non-proliferative diabetic retinopathy (NPDR), Proliferative diabetic retinopathy (PDR)