Clinical relevance of correlating the degree of retinopathy with the blood glycated

1 Advances in Environmental Biology, C(): CC-CC, 2009 ISSN 1995-0756 © 2009, American-Eurasian Network for Scientific Information

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O RIGINAL A RTICLE

Clinical Relevance of Correlating the Degree of Retinopathy with the Blood Glycated Hemoglobin Concentration in Patients with Type 2 Diabetes Mellitus
1Guillermo Gutiérrez-Espindola, 2Roberto De Haro, 3Segundo Morán, 3Alexander Krouham, 3Ricardo Washington and 4José D. Méndez

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Department of Hematology, Specialties Hospital, National Medical Center, Mexican Institute of Social Security, Mexico City, 06703 D.F., Mexico 2 Medicine Section, Iztacala Faculty, National Autonomous University of Mexico, Los Reyes Iztacala, Tlalnepantla, State ofMexico, 54090, Mexico. 3 Department of Internal Medicine, ABC Medical Center, Mexico City, Mexico 4 Medical Research Unit in Metabolic Diseases, National Medical Center, Mexican Institute of Social Security, P.O. Box A-047, Mexico City, 06703 D.F., Mexico Guillermo Gutiérrez-Espindola, Roberto De Haro, Segundo Morán, Alexander Krouham, Ricardo W ashington and José D. Méndez; Clinical Relevance ofCorrelating the Degree of Retinopathy with the Blood Glycated Hemoglobin Concentration in Patients with Type 2 Diabetes Mellitus, Am.Eurasian J. Sustain. Agric., C(): CC-CC, 2009 ABSTRACT Diabetic retinopathy is the leading cause of blindness in the working age population. Glycated hemoglobin (HbA 1c), the product of the reaction between glucose and hemoglobin, markedly increases in hyperglycemicdiabetic patients, is a reliable measure of glucose levels during the last two to three months and, even so, has been neglected as a reliable indicator of diabetes-induced damage to organs and tissues in diabetic patients by practicing physicians. In this study we tried to find out if the blood HbA 1c concentration correlates with the degree of retinopathy in a group of type 2 diabetic patientsattending a third level hospital in Mexico City. 36 diabetic patients (28 women and 8 men) with a mean age of 56 years (22 to 85 years) participated in this study. The results show a positive correlation between the blood HbA 1c concentration and both, the degree of retinopathy and the time in years suffering from diabetes mellitus (p # 0.05). These results show that the assessment of the blood HbA1c concentration could be used to infer damage to the retina by practicing physicians, and could eventually be useful to diabetic patients too, if they were acquainted to what having increased blood HbA 1c concentrations means. Key words: Type 2 diabetes mellitus, Glycated hemoglobin, Diabetic retinopathy, Neuropathy. Introduction Diabetic retinopathy, a non-inflammatory degenerative disease ofthe retina, is a microvascular complication of diabetes mellitus that affects type 1 and 2 diabetic patients when these have a poor compliance with medical treatment, but can also occur as the normal course of the disease after some Corresponding Author Dr. José D. Méndez, Medical Research Unit in Metabolic Diseases National Medical Center Mexican Institute of Social Security P.O. Box A-047 MexicoCity, 06703, D.F Mexico E-mail: mendezf@servidor.unam.mx years in type 1 diabetic patients [1-3]. Diabetic retinopathy is divided into background and proliferative, being the latter the most advanced [4, 5]. Diabetic retinopathy usually leads to vision loss when it is not treated promptly and appropriately. The precipitating cause seems to be the increase in serum glucose concentration [1-5].Adv. Environ. Biol., C():CC-CC, 2009 Glycated hemoglobin (HbA 1c) forms as a nonenzymatic reaction between glucose and hemoglobin, specifically the amino acid valine of the â chain of A hemoglobin [6]. HbA 1c is an indicator of the longterm average blood glucose concentrations[7], and has been used to estimate the risk of cardiovascular [8] and liver diseases [9], and even death from any cause...