Clinical study on association of diabetic retinopathy severity with HbA1c level

Abstract

Patients with diabetic retinopathy (DR) have a greater risk of blindness compared to those without diabetes. HbA1c is a valuable indicator used to assess the long-term management of diabetes mellitus. Hence, the main objective of this study was to explore the relationship between HbA1c levels and the severity of diabetic retinopathy.This one-year prospective observational clinical study was conducted at the Department of Ophthalmology and Diabetic Clinic, Gandhi Medical College, Bhopal, involving 100 diabetic patients. Detailed medical histories related to their diabetes were recorded. The diabetic retinopathy status of each patient was assessed through a comprehensive ophthalmologic examination and classified according to the early treatment diabetic retinopathy study (ETDRS) system. Clinical data of the patients, including HbA1c levels, were gathered during the study period.Among the 100 patients, 29% were females, while the remaining 71% were males. A notable finding emerged, revealing a significant link between the severity of diabetic retinopathy and HbA1c levels. Additionally, the duration of diabetes and lipid levels also demonstrated a significant association with the severity of retinopathy (P value < 0.05). However, the age and gender of the patients did not exhibit a significant correlation when compared across different grades of diabetic retinopathy (P value > 0.05). ROC analysis revealed that an HbA1c cutoff of 7.6% was the most effective in detecting both the presence of any diabetic retinopathy and its grades. A strong statistical relationship was found between HbA1c levels and the severity of diabetic retinopathy. Patients with higher HbA1c levels, indicating poorer blood sugar control, showed more severe grades of diabetic retinopathy. HbA1c levels emerged as a reliable predictor for both the presence and severity of diabetic retinopathy.