The Role of Systemic Risk Factors in Diabetic Retinopathy

Abstract

Diabetic retinopathy is an increasingly common medical issue in the United States. The risk of developing the disease or having the disease progress is caused by many systemic health factors. This article examines the existing literature on the links between glycemic control, arterial hypertension, high cholesterol and hyperlipidemia, obesity, inflammatory markers, sleep-disordered breathing, and exercise with risk of diabetic retinopathy development and prevention. The literature shows benefit for good glycemic and blood pressure control. The effects of cholesterol, and lipid control, inflammatory markers, sleep-disordered breathing, obesity, and exercise are less well established.

Diabetic Retinopathy–An Underdiagnosed and Undertreated Inflammatory, Neuro-Vascular Complication of Diabetes

“…The authors hypothesized that the change in bile acid metabolism due to the restructured gut microbiome favored increased endogenous generation of TUDCA, a neuroprotective bile acid (with receptors demonstrated in retinal ganglion cells) offering a protective effect against injury (70). Such reactions appear to be related, not just to the overall average serum and tissue glucose, but also to variability in glucose concentration (71). However, additional research is warranted to further test if the microbiota is a risk factor for diabetic retinopathy.…”

Effects of Glucan and Vitamin D Supplementation on Obesity and Lipid Metabolism in Diabetic Retinopathy

“…In overweight people, this risk is less pronounced [ 4 ]. In cases of BMI higher than 40, the risk of developing DR is five times higher than in people with normal weight [ 5 ].…”

“…They clearly result in higher risk of vision damage and DR. HDL and triglycerides levels play an unknown role; the clinical findings are statistically insignificant. On the other hand, higher physical activity is one of the preventive steps leading to significant reduction of DR development [ 5 ]. Polysaccharides and glucans, in particular, play a significant role in the prevention of the metabolic syndrome and reduction of obesity [ 6 - 8 ].…”

The Role of Hypertension and Dyslipidaemia in the Progression of Diabetic Retinopathy in Type 2 Diabetes

“…Moreover, increased stretch of retinal microvasculature to accommodate changes in BP leads to up regulation of VEGF receptors [14]. VEGF receptors also increases by activation of the renin-angiotensin system, which augments angiotensin-II binding to AT-I receptor [16]. Increase in VEGF and its receptors leads to basement membrane thickening, increased vascular permeability and revascularization [14].…”