Diabetic Retinopathy And Diabetic Eye Problems
Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. Diabetic retinopathy (DR) is a chronic progressive, potentially sight-threatening disease of the retinal microvasculature, associated with the prolonged hyperglycaemia of diabetes mellitus and with other diabetes mellitus-linked conditions, such as hypertension. Diabetes mellitus can cause a variety of eye problems, the most common being DR, which is the most common cause of severe sight impairment among people of working age in England, Wales and Scotland.[1] Other conditions associated with diabetes and the eye include: Cataracts. Rubeosis iridis and glaucoma. Ocular motor nerve palsies. Diabetic retinopathy The exact mechanism by which diabetes leads to DR is not fully understood. Microvascular occlusion causes retinal ischaemia leading to arteriovenous shunts and neovascularisation. Leakage results in intraretinal haemorrhages and localised or diffuse oedema. These processes result in the characteristic features seen at various stages of DR: Microaneurysms - physical weakening of the capillary walls which predisposes them to leakages. Hard exudates - precipitates of lipoproteins/other proteins leaking from retinal blood vessels. Haemorrhages - rupture of weakened capillaries, appearing as small dots/larger blots or 'flame' haemorrhages that track along nerve-fibre bundles in superficial retinal layers (the haemorrhage arises from larger and more superficial arterioles). Cotton wool spots - build-up of axonal debris due to poor axonal metabolism at the margins of ischaemic infarcts. Continue reading >>
Reference
This purpose of this talk is to overview the 2017 American Diabetes Association Standards of Medical Care in Diabetes. These Standards comprise all of the current and key clinical practice recommendations of the American Diabetes Association. [SLIDE] 2 Reference American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care 2014;37(suppl 1):S1 A few notes on the Standards of Care: The Association funds development of the Standards of Care and all Association position statements out of its general revenues and does not use industry support for these purposes [CLICK] The slides are organized to correspond with sections within the 2017 Standards of Care. As we go through I’ll make note of where we are within the document. [CLICK] Though not every section in the document is represented, these slides do incorporate the most salient points from the Position Statement As with all Association position statements, the Standards of Care are reviewed and approved by the Association’s Board of Directors, which includes health care professionals, scientists, and lay people. [SLIDE] 3 These Standards of Care are revised annually by the ADA’s multidisciplinary Professional Practice Committee (PPC) [CLICK] For the 2017 revision, PPC members systematically searched Medline for human studies related to each subsection and published since 1 January 2016. [CLICK] Recommendations were revised based on new evidence or, in some cases, to clarify the prior recommendations or match the strength of the word to the strength of the evidence [CLICK] A table linking the changes in the recommendations to new evidence can be reviewed at professional.diabetes.org/SOC (Standards of Care) [CLICK] The Association and the Professional Practice Committee Continue reading >>
Every 24 Hours
Diabetic Microvascular Disease: The Role of Glycemic Control and the Impact on Public Health Robert E. Ratner, MD MedStar Research Institute Georgetown University Medical School Washington, DC EVERY 24 HOURS New Cases – 4,100 Amputations – 230 (60% of non-traumatic amputations annually) Blindness – 55 (#1 cause) Kidney Failure – 120 (#1 cause) Derived from NIDDK, National Diabetes Statistics fact sheet. HHS, NIH, 2005. The following are rough approximations to help emphasize what diabetes prevalence numbers mean to people with diabetes each and every day. Approximately, 4,100 new cases of diabetes diagnosed; 810 people die from the complications of diabetes; 230 people with diabetes will have an amputation; 120 people with diabetes will suffer from kidney failure; and 55 people with diabetes will go blind. Reference National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics fact sheet: general information and national estimates on diabetes in the United States, 2005.Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2005. Continue reading >>
Yehuda Handelsman Md, Facp, Face, Fnla
AACE Clinical Practice Guidelines for Diabetes Mellitus Writing Committee Task Force 2 Timothy S. Bailey, MD, FACP, FACE, ECNU Lawrence Blonde MD, FACP, FACE George A. Bray, MD, MACP, MACE A. Jay Cohen MD, FACE, FAAP Samuel Dagogo-Jack, MD, DM, FRCP, FACE Jaime A. Davidson, MD, FACP, MACE Daniel Einhorn, MD, FACP, FACE Om P. Ganda, MD, FACE Alan J. Garber, MD, PhD, FACE W. Timothy Garvey, MD Robert R. Henry, MD Irl B. Hirsch, MD Edward S. Horton, MD, FACP, FACE Daniel L. Hurley, MD, FACE Paul S. Jellinger, MD, MACE Lois JovanoviÄ, MD, MACE Harold E. Lebovitz, MD, FACE Derek LeRoith, MD, PhD, FACE Philip Levy, MD, MACE Janet B. McGill, MD, MA, FACE Jeffrey I. Mechanick, MD, FACP, FACE, FACN, ECNU Jorge H. Mestman, MD Etie S. Moghissi, MD, FACP, FACE Eric A. Orzeck, MD, FACP, FACE Paul D. Rosenblit, MD, PhD, FACE, FNLA Aaron I. Vinik, MD, PhD, FCP, MACP, FACE Kathleen Wyne, MD, PhD, FNLA, FACE Farhad Zangeneh, MD, FACP, FACE  Reviewers Lawrence Blonde MD, FACP, FACE Alan J. Garber, MD, PhD, FACE Copyright © 2015 AACE. May not be reprinted in any form without express written permission from AACE. AACE DM CPG Objectives and Structure This CPG aims to provide the following: An evidence-based education resource for the development of a diabetes comprehensive care plan Easy-to-follow structure 24 diabetes management questions 67 practical recommendations Concise, practical format that complements existing DM textbooks A document suitable for electronic implementation to assist with clinical decision-making for patients with DM 3 Copyright © 2015 AACE. May not be reprinted in any form without express written permission from AACE. AACE DM CPG Evidence Ratings and Grades 4 Evidence level Evidence grade Semantic descriptor 1 A Meta-analysis of randomized controlled trials Continue reading >>
Asymmetric Diabetic Retinopathy
Nabil El Hindy, Ophthalmology Department, Norfolk & Norwich NHS Trust, Colney Lane, NR4 7UY Norwich, UK.Tel: +441603286286; Fax: +441603288261Email: [email protected] Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Diabetic retinopathy is primarily a microangiopathy. In response to the ischemia, retinal tissues release various angiogenic and inflammatory factors that enhance vascular growth and permeability, leading to progression of diabetic retinopathy. The fundoscopic findings in the vast majority of patients tend to be symmetrical. Asymmetric findings should prompt further investigation. A 73yearold man with Type 2 diabetes mellitus for the past 15 years was routinely followedup on an annual basis in the eye clinic. Over the duration of followup, fundoscopy had shown only minimal background diabetic retinopathy. Over a period of 10 months, the patient developed very marked asymmetric retinopathy that was resistant to extensive treatment with panretinal photocoagulation. During this period, the patients HbA1c was 8.6%. His medical history included hypertension and hypercholesterolemia, for which he was on oral medication. He also had a history of peripheral vascular and ischemic heart disease. At examination, corrected visual acuities were 6/12 in the right eye and 6/6 in the left eye. The right fundus had extensive proliferative changes, with a fan of new vessels arising from the optic disc with an inner fibrous band. In contrast, the left fundus showed signs of mild nonproliferative diabetic retinopathy ( Fig.1 ). Ocular e Continue reading >>
Diabetic Retinopathy
Diabetic retinopathy, also known as diabetic eye disease, is a medical condition in which damage occurs to the retina due to diabetes and is a leading cause of blindness.[1] It affects up to 80 percent of people who have had diabetes for 20 years or more.[2] At least 90% of new cases could be reduced if there were proper treatment and monitoring of the eyes.[3] The longer a person has diabetes, the higher his or her chances of developing diabetic retinopathy.[4] Each year in the United States, diabetic retinopathy accounts for 12% of all new cases of blindness. It is also the leading cause of blindness for people aged 20 to 64 years.[5] Signs and symptoms[edit] Normal vision The same view with diabetic retinopathy. Emptied retinal venules due to arterial branch occlusion in diabetic retinopathy (fluorescein angiography) Diabetic retinopathy often has no early warning signs. Even macular edema, which can cause rapid vision loss, may not have any warning signs for some time. In general, however, a person with macular edema is likely to have blurred vision, making it hard to do things like read or drive. In some cases, the vision will get better or worse during the day. In the first stage which is called non-proliferative diabetic retinopathy (NPDR) there are no symptoms, the signs are not visible to the eye and patients will have 20/20 vision. The only way to detect NPDR is by fundus photography, in which microaneurysms (microscopic blood-filled bulges in the artery walls) can be seen. If there is reduced vision, fluorescein angiography can be done to see the back of the eye. Narrowing or blocked retinal blood vessels can be seen clearly and this is called retinal ischemia (lack of blood flow). Macular edema in which blood vessels leak their contents into the macular regi Continue reading >>
Ppt Presentation - Vissioneyes.com
Our commitment to clinical excellence is lead by our Senior Doctor, Himanshu Mehta, a world-renowned optical surgeon, who has performed over 5,000 refractive treatments. His wealth of experience ensures that The Vission Eye Center stays at the forefront of corrective eye surgery innovation and maintains the highest standards of patient care. The Vission Eye Center closely monitors the results of its specialist medical team. Dr. Himanshu Mehta has been in practice for over twenty years. He has done his undergraduate and postgraduate training in Ophthalmology from one of the most reputed schools of medicine in Asia. Dr. Mehta entered Seth G.S. Medical College and KEM Hospital Mumbai and also received a Masters in Surgery M.S. (Ophthalmology) from Mumbai University.He has done his super specialty training in Ophthalmology from Houston, Texas in the United States. In order to become further qualified, Dr. Mehta engaged in a Fellowship in Vitreo-Retinal surgery with Dr. Charles A. Garcia, Director Retina Services at Memorial Hermann Hospital in Houston, Texas. Dr. Mehta was also involved in some of the early studies in Excimer Laser with Dr. Warren Cross in the United States. Professional affiliations of Dr. Himanshu Mehta include: American Society of Cataract and Refractive Surgery Dr. Mehtas area of interest is Cataract and Phaco-Emulsification Surgery and Vitreo-Retinal Surgery. He has to his credit more than 5000 surgeries. He has operated some of the oldest living patients (around the ages of 105) and has successfully restored sight in them. He is skilled to perform the most complicated cases from cataract to LASIK surgery to retinal detachment surgery. He endeavours to reduce blindness due to diabetes and is involved in patient education and treatment for the same. Dr Continue reading >>
Aravind Eye Care System Aravind Eye Hospital & Postgraduate Institute Of Ophthalmology Madurai, India
Dr. P. Namperumalsamy, MS, FAMS Chairman Emeritus Models of Delivery of Services in Diabetic Retinopathy */37 A R A V I N D E Y E C A R E S Y S T E M VISION 2020 –The Right to Sight Vision 2020 India World Health Organization Cataract Childhood blindness Refractive errors & low vision Corneal blindness Glaucoma Diabetic retinopathy Trachoma (Focal) */37 A R A V I N D E Y E C A R E S Y S T E M Global projections for the diabetes epidemic: 2007-2025 (millions) IDF Atlas 2003 World 2007 = 246 million 2025 = 380 million Increase 55% 46.5 80.3 73% 67.0 99.4 48% 10.4 18.7 80% 24.5 44.5 81% 53.2 64.1 21% 28.3 40.5 43% 16.2 32.7 102% Sicree, Shaw, Zimmet. Diabetes Atlas. IDF www.idf.org. 2006 0 */37 * * Checked & correct November 3 2006. Atlas will be published by IDF in Dec 2006. The regions are IDF regions. In each box, the top figure is the number of people with DM in 2007, the bottom figure is 2025, and the % is the increase. Data include all those with diagnosed and undiagnosed DM. Data are based on best available studies for each country. Where no good studies are available, data from another country are projected onto the national population. Age range is 20-79. A R A V I N D E Y E C A R E S Y S T E M Fact #1: 20 - 40% have DR BDES, Beaver Dam Eye Study; BMES, Blue Mountains Eye Study; VIP, Visual Impairment Project; VER, Vision Evaluation Research; SAHS, San Antonio Heart Study; SLVDS, San Luis Valley Diabetes Study; WESDR, Wisconsin Epidemiologic Study of Diabetic Retinopathy; */37 A R A V I N D E Y E C A R E S Y S T E M India - 20% have DR Prevalence of DR -17.6% Prevalence of DR 12 . 2% Prevalence of DR - 18% */37 A R A V I N D E Y E C A R E S Y S T E M Diabetic Retinopathy Blindness in Cataract Vs Vision impairment in D.R. Curable Blindness : Cataract Vs Prev Continue reading >>
Diabetic Retinopathy Clinical Presentation
In the initial stages of diabetic retinopathy, patients are generally asymptomatic; in the more advanced stages of the disease, however, patients may experience symptoms that include floaters, blurred vision, distortion, and progressive visual acuity loss. Continue reading >>
Hustling Hope: Doctors Debunk Diabetes Treatment As Fraud Charges Hit Clinicexecutive
Hustling Hope: Doctors Debunk Diabetes Treatment As Fraud Charges Hit ClinicExecutive Above: Ford Gilbert, founder and CEO of Trina Health, is shown in an office at the companys Sacramento headquarters on Feb. 5, 2018. He is flipping through a PowerPoint presentation he uses to explain to investors the effects of the Trina IV insulin infusion procedure. Just imagine: A nonsurgical treatment that helps millions of people with complications from diabetes restore vision, repair damaged kidneys, and reverse heart disease and cognitive decline. A treatment that heals wounds in their legs and feet, repairs damage from stroke, and eliminates a common type of diabetic nerve pain called neuropathy. Thats what lawyer G. Ford Gilbert and his network of Trina Health clinics have been promising with his IV insulin infusions offered through his Sacramento-based company. The Trina CEO calls the procedure miraculous, and the first real change in treatment for people with Type 1 or Type 2 diabetes since the 1921 discovery of insulin . inewsource has spent months investigating a California lawyer and his practices in promoting what he calls a miraculous procedure for reversing the complications of diabetes, a condition that affects 30.3 million Americans. Senior healthcare reporter Cheryl Clark began asking questions about the insulin infusion procedure advertised by Trina Health after learning it was being offered in San Diego. The inewsource mission is accountability journalism, and Clark focused her inquiries on the risk of harm to patients and the cost to the healthcare system. She has interviewed dozens of people for this investigation, including Trina founder and CEO G. Ford Gilbert at his Sacramento headquarters. Gilbert was charged with fraud and bribery in Alabama in a federal Continue reading >>
Ppt - Best Eyecare Hospitals In Chennai | Drr Eyecare Hospitals Powerpoint Presentation - Id:7835846
Best Eyecare Hospitals in Chennai | Drr Eyecare hospitals PowerPoint Presentation Best Eyecare Hospitals in Chennai | Drr Eyecare hospitals DRR eye hospital is known for providing global standards of eye care at affordable cost. With a dedicated, experienced and skilled team of medical professionals, use of cutting edge technology and latest infrastructure in place, it is equipped to deliver the best possible eye care to its patients\n I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described. PowerPoint Slideshow about 'Best Eyecare Hospitals in Chennai | Drr Eyecare hospitals' - monish An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - DRR eye hospital is known for providing global standards of eye care at affordable cost. With a dedicated, experienced and skilled team of medical professionals, use of cutting edge technology and latest infrastructure in place, it is equipped to deliver the best possible eye care to its patients. DRR Eye Hospital, has been committed to providing comprehensive and state of the art eye care services, for over a decade now. With a dedicated, experienced and skilled team of medical professionals, use of cutting edge technology and latest infrastructure in place, DRR Eye Hospital is equipped to deliver the best possible eye care to pat Continue reading >>
Diabetic Retinopathy: Clinical Findings And Management
Diabetic Retinopathy: Clinical Findings and Management K Viswanath , MS DO MSc and D D Murray McGavin , MD FRCSEd FRCOphth Head of the Department of Ophthalmology, Osmania Medical College, Deputy Medical Superintendent, Regional Institute of Ophthalmology, Sarojini Devi Eye Hospital, Hyderabad 500 028, Andhra Pradesh, India Editor, Journal of Community Eye Health, Medical Director, International Resource Centre, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK Copyright 2003 Journal of Community Eye Health International Centre for Eye Health, London This article has been cited by other articles in PMC. Diabetes mellitus is a metabolic abnormality in which there is a failure to utilise glucose and hence a state of hyperglycaemia can occur. If hyperglycaemia continues uncontrolled over time, it will lead to significant and widespread pathological changes, including involvement of the retina, brain and kidney. In industrialised countries, approximately 1% of the population is diabetic, and at least another 1% are undiagnosed diabetics. Insulin dependent diabetes (IDDM), accounts for approximately 1015% of cases, the remainder being maturity onset or non-insulin dependent diabetics (NIDDM). Diabetes mellitus is an international public health problem with estimated prevalences ranging from 2.0% to 11.7% in studied populations across the world. 1 Diabetic retinopathy is increasingly becoming a major cause of blindness throughout the world in the age group of 2060 years. 2 , 3 , 4 Loss of productivity and quality of life for the patient with diabetic retinopathy will lead to additional socio-economic burdens on the community. Diabetic retinopathy is the cause of blindness in approximately 2.5 million of th Continue reading >>
Case Report: Proliferative Diabetic Retinopathy In Typical Retinitis Pigmentosa
Proliferative diabetic retinopathy in typical retinitis pigmentosa Find articles by Srinivasaraghavan Preethi Find articles by Adithyapuram Ramachandran Rajalakshmi 1Cataract & Medical Retina Services, Vasan Eye Care, Chennai, Tamil Nadu, India 2Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India Correspondence to Dr Adithyapuram Ramachandran Rajalakshmi, [email protected]_ra A 39-year-old woman with typical retinitis pigmentosa (RP) for 9 years and a positive family history of night blindness was diagnosed with diabetes mellitus (DM). She developed proliferative diabetic retinopathy (PDR) during the course of disease. She was promptly managed with pan retinal photocoagulation (PRP). PDR developing in a case of typical RP is extremely rare and has not been reported in the literature to date. Recognition of this rare, vision threatening complication, points out a definite need to further look deep into the pathogenesis of diabetic retinopathy. Diabetic retinopathy is an important cause of preventable blindness and retinitis pigmentosa is an ocular condition known to have a protective effect against development of diabetic retinopathy. 1 We describe a case of a 39-year-old woman with typical retinitis pigmentosa who developed proliferative diabetic retinopathy. To the best of our knowledge, this is the first case to be reported of proliferative diabetic retinopathy in a case of typical retinitis pigmentosa. A 39-year-old woman presented with painless progressive loss of vision of 1 year duration, more in the left than the right eye. She had night blindness for 9 years and a significant positive family history of night blindness, with her father and two siblings having similar symptoms. She was a diabetic on treatment wit Continue reading >>
Dka Case Presentation Ppt
Ketoacidosis: High anion gap metabolic acidosis due to excessive blood concentration of ketone bodies (Ketoanion). . Cerebral Edema 11. 2; BE 20. common emergency presentations seen in diabetes: hyperglycaemia, presenting as DKA (diabetic ketoacidosis) or HONK (hyperosmolar non-ketotic hyperglycaemia), 1. Presentation Outline. For more everyday 16 Jul 2012 developed a business case to use this cost saving to develop new CSII centres across the country, to increase . 29, PCO2 36, PO2 76, HCO3 17. case. pH 7. Many cases could be prevented by better access to medical care, education and effective communication between patients and health professionals during concurrent Clinical presentation and diagnosis. A 45-year-old housewife presented to emergency department with complaints of fever for 2 days followed by sudden onset weakness of all four limbs, which was List major electrolyte abnormalities in diabetic ketoacidosis and any associated complications. The patient was diagnosed with diabetic ketoacidosis (DKA), and was suspected to have bacterial meningitis as a precipitant, until imaging revealed a pituitary macroadenoma. Stressful precipitating event that results in increased catecholamines, cortisol, glucagon. ppt. 3. Cohort studies. First bolus: 10ml/kg N/Saline remained hypotensive; Second bolus 10ml/kg N/Saline: still hypotensive, but Management of Diabetic Ketoacidosis. DKA. Have an overall understanding of diabetic ketoacidosis in a pediatric patient. Woman, 39 . guidelines should be commenced (See Appendix 2. DKA is a classic presentation for new-onset diabetes (both type 1 and type 2), and these constitute about one-third of the DKA cases. Different from DKA. DISCLOSURES. Case. 18. 2. Abdominal pain appears to be related to the presence of metabolic Clinical Pr Continue reading >>
Educate Physicians And Nurses On Practical Management Tips For Diabetes Control.
Type 2 Diabetes Common in Hispanics, Native Americans and Pima Indians Incidence of ESRD is lower, but the disease is more frequent – thus it is the most common cause of renal failure United Kingdom Prospective Diabetes Study UKPDS – large British study, (predominantly Caucasians) Adler, AI, Stevens, RJ, Manley, SE, Bilous, RW, Cull, CA & Holman, RR: Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int, 63:225-32, 2003. Incidence of microalbuminuria 25% but incidence of ESRD only 0.8% Microlbuminuria patients spent an average of 11 years before progressing to overt proteinuria Only 2.3% progress from macroalbuminuria to ESRD 1. Hypertension in people with Type 2 diabetes: knowledge-based diabetes-specific guidelines. Diabet Med, 20:972-87, 2003. 2. Abbott, KC & Bakris, GL: What have we learned from the current trials? Med Clin North Am, 88:189-207, 2004. 3. Anderson, PW, McGill, JB & Tuttle, KR: Protein kinase C beta inhibition: the promise for treatment of diabetic nephropathy. Curr Opin Nephrol Hypertens, 16:397-402, 2007. 4. Baghdasarian, SB, Jneid, H & Hoogwerf, BJ: Association of dyslipidemia and effects of statins on nonmacrovascular diseases. Clin Ther, 26:337-51, 2004. 5. Bakris, GL, Weir, MR, Shanifar, S, Zhang, Z, Douglas, J, van Dijk, DJ & Brenner, BM: Effects of blood pressure level on progression of diabetic nephropathy: results from the RENAAL study. Arch Intern Med, 163:1555-65, 2003. 6. Bando, Y, Ushiogi, Y, Okafuji, K, Toya, D, Tanaka, N & Miura, S: Non-autoimmune primary hypothyroidism in diabetic and non-diabetic chronic renal dysfunction. Exp Clin Endocrinol Diabetes, 110:408-15, 2002. 7. Berl, T, Hunsicker, LG, Lewis, JB, Pfeffer, MA, Porush, JG, Rouleau, JL Continue reading >>
