Retinopathy k. Diabetes and related treatments
Retinopathy. Retinopathy affects approximately a third of adults with diabetes and is the main cause of blindness among this population. If retinopathy is detected early through retinal screening, it can be treated and vision can be restored, and studies have suggested that the incidence of diabetic retinopathy has declined in recent years (Xxxxxxx, 2019). Retinopathy is a result of chronic hyperglycaemia, but its progression is also influenced by blood pressure and, to a lesser extent, lipid levels. The condition known as macular oedema is more prevalent than proliferative retinopathy. Complications associated with diabetic retinopathy can include vitreous haemorrhage, retinal detachment, and neovascular glaucoma, as well as blindness (Megherbi et al., 2003). Lower extremity amputations (LEA’s) Having diabetes can lead to serious foot problems and amputation. LEAs are a major complication of diabetes as they pose not only a physical burden, but also an economic and psychosocial one. However, the incidence of LEAs is reported to have declined in recent years (Xxxxxxx, 2019). The ENTRED study found a prevalence of healed or unhealed foot ulcers of 6%; however, 15% of people with T2DM are expected to develop foot ulcers during their lifetime (Xxxxxxx et al., 2003). Lower limb amputations account for more than half of all amputations in people with diabetes, demonstrating the severity of these lesions, as 85 percent of amputations in T2DM are preceded by foot ulceration. Trophic foot disorders are the result of the interaction of three major complications of diabetes (Xxxxxxx et al., 2005): i) sensory neuropathy contributing to the foot's insensitivity to trauma (inappropriate footwear, aggressive pedicure care) and a loss of painful alertness, which favours foot osteoarthritis, deformities, and hyper-support; ii) distal diabetic arteritis and capillary circulation disorders impairing tissue oxygenation, resulting in slower healing, and increasing the risk of amputation-related gangrene; iii) increased risk of infection associated with metabolic abnormalities exacerbating the situation by promoting deep bone and/or widespread dissemination.
