Glycated Haemoglobin and Diabetic Retinopathy in Type 2 Diabetic Patients in HRH Princess Maha Chakri Sirindhorn Medical Center
Tangjai, P.; Chingchana, P.; Taweerutchana, R.
Journal of the Medical Association of Thailand 98(Suppl 10): S135-S142
2015
ISSN/ISBN: 0125-2208 PMID: 27276846 Document Number: 16555
Diabetic retinopathy (DR) is an important cause of blindness in type 2 diabetic patients. When it occurs, it affects the patient's quality of life including their physical activity, emotion, mentality, and social interactions. Therefore, the objectives of this research were to study the relationship between glycaemic control and DR and the relationship between DR and other factors. We also aim to find the optimal cut-off point to screen diabetic retinopathy using glycated haemoglobin (HbA₁c) levels. We performed a case-control study. One hundred patients were divided into two groups (50 patients for DR group and 50 patients for non-DR group). Their HbA₁c, weight, height, blood pressure, and lipid profiles were retrospectively reviewed by Electronic Medical Record (EMR). The data was analysed using both Chi-square test and logistic regression with two-tailed hypothesis. The research revealed that uncontrolled glycaemic in type 2 diabetic patients was significantly related to DR (Adjusted odds ratio 8.89, 95% CI = 2.3-18.00, p-value < 0.001). In addition, it occurred more commonly in males (Adjusted odds ratio 6.41, 95% CI = 3.02-26.25, p-value < 0.001). A cut-off level of HbA₁c for screening DR is 7.25% (sensitivity 84%, specificity 66%, positive predictive value = 71.2%, negative predictive value = 80.5%). HbA₁c level and male gender are strongly related to DR (p < 0.001) and the optimal cut-off level for DR screening is 7.25% in type 2 diabetic patients that were treated in HRH Princess Maha Chakri Sirindhorn Medical Center.