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Related Concept Videos

Diabetic Retinopathy01:27

Diabetic Retinopathy

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DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
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Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Hyperglycemia01:29

Hyperglycemia

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Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose...
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Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

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Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated...
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Diabetic Nephropathy01:28

Diabetic Nephropathy

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Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration...
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Type I Diabetes II: Pathophysiology01:26

Type I Diabetes II: Pathophysiology

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Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular...
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Glycemic variability and diabetes retinopathy: a missing link.

Cherng-Ru Hsu1, Yu-Tsung Chen2, Wayne H-H Sheu3

  • 1Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.

Journal of Diabetes and Its Complications
|December 24, 2014
PubMed
Summary

Glycemic variability impacts diabetic retinopathy. Short-term glucose fluctuations may worsen retinopathy in type 2 diabetes, while long-term HbA1c variation strongly associates with retinopathy in types 1 and 2 diabetes.

Keywords:
Diabetes retinopathyGlycemic variabilityMacrovascular complicationsMicrovascular complicationsPostprandial hyperglycemia

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Area of Science:

  • Endocrinology
  • Ophthalmology
  • Metabolic Disorders

Background:

  • Glycemic variability, including fasting plasma glucose fluctuation and postprandial hyperglycemia, is linked to macrovascular complications in diabetes.
  • The association between glycemic variability and microvascular complications, specifically diabetic retinopathy, remains debated.

Purpose of the Study:

  • To review existing evidence on the relationship between glycemic variability and diabetic retinopathy in patients with type 1 and type 2 diabetes.

Main Methods:

  • Systematic review of current scientific literature.
  • Analysis of studies examining glycemic variability metrics (e.g., standard deviation of fasting glucose, HbA1c variation) and their correlation with diabetic retinopathy.

Main Results:

  • Short-term glycemic fluctuations may contribute to diabetic retinopathy development/progression in type 2 diabetes.
  • Long-term glycemic variability (HbA1c variation) shows a stronger association with diabetic retinopathy in both type 1 and type 2 diabetes.

Conclusions:

  • Reducing glycemic variability is crucial for preventing or slowing the progression of diabetic retinopathy in all diabetes types.
  • Both short-term and long-term glycemic fluctuations warrant clinical attention in managing diabetic retinopathy risk.