RETINA STATE IN PATIENTS WITH DIABETES TYPE 2 TRANSFERRED TO INSULIN THERAPY
Objеctivе. To analyze the factors affecting the diabetic retinopathy (DR) course in transition to the insulin therapy.
Matеrials and mеthods. The results of the ophthalmological examinations of 32 patients with diabetes type 2 (64 eyes) transferred to the insulin therapy are presented. The average age was of 59.0±2.3 years. The patients were divided into groups depending on the DR stage: Group 1 consisted of patients with non-proliferative DR, Group 2 - of those with preproliferative DR, and Group 3 - of subjects with proliferative DR. The study had been conducted before the insulin therapy was prescribed and in 6 months after.
Rеsults. After 6 months had passed, the diabetic retinopathy progression in Group 1 was registered in 17.8% of cases (5 eyes), in Group 2 - in 42.3% (11 eyes) of cases, in Group 3 - in 80% (8 eyes) of cases. The DR progression was observed in 16.6% of the patients having BMl <25 kg/m2, 45.4% of subjects having BMl 25 kg/m2 to 30 kg/m2, and in 53.3% of those having BMl <30 kg/m2. The HbA1c level decreased by 1.6%±0.02% in average but did not reach the normal value (6.0%). The DR presence and severity in patients with diabetes type 2 was clearly associated with a high blood pressure. Conclusion. When transferring a patient to the insulin therapy the doctor should consider the following factors: the retina initial state, the body mass index, the glycated hemoglobin level, the diabetes duration, hypertension presence and severity.