Association of diabetic nephropathy with diabetic retinopathy in type 2 diabetes mellitus patients

Background: Microvascular complications of Type 2 Diabetes Mellitus (T2DM), (retinopathy and nephropathy) have a similar etiopathogenetic mechanism besides genetic predisposition. Even though these two complications frequently co-exist, their frequency varies. The association of these two significant complications and their co-existence needs a relook. Methods: Four hundred patients suffering from type 2 DM visiting a tertiary care hospital in Western India were included in this cross-sectional study. Of these, 200 patients were of Diabetic Nephropathy (DN) and 200 were without DN. The presence of albuminuria (urine albumin-creatinine ratio) was used to detect diabetic nephropathy. Fundoscopy was performed in all patients to look for Diabetic Retinopathy (DR). Results: In this study, 77.5% patients with DN had retinopathy, while in patients without DN, only 52% patients had retinopathy. This was a statistically significant finding. (p value <0.001). The distribution of types of retinopathy in patients with DN was 63.0% Non-Proliferative Diabetic Retinopathy (NPDR), 12.5% Proliferative Diabetic Retinopathy (PDR) and 2% Clinically Significant Macular Edema (CSME). While in those without DN, 50.5% had NPDR, 1.5% had PDR and none had macular edema. Conclusions: Microalbuminuria, which has been used so far to diagnose DN, may be considered as a reliable predicter of diabetic retinopathy in type 2 diabetes mellitus patients. This simple marker can help screen all patients with Diabetes for nephropathy and retinopathy both and should take place at the first visit/ contact of the healthcare personnel. This can help prevent microvascular complications early and help in goal directed therapy.