November 23, 2011 | POSTED BY | Clinical Pearls

Type 1 ~ 10% of cases

  • Beta cell destruction
  • Immune mediated
  • Absolute Insulin deficiency
  • Tx Exogenous insulin for survival
  • 100% will have DR / 56% PDR @ 20 years

Type 2 ~ 90% of cases

  • Peripheral insulin resistance
  • Insulin deficiency or secretory defect
  • Tx diet, exercise, oral hypoglycemic
  • >60% have DR / 20% PDR @ 20 years

 

Diabetic Case History

  • Duration
  • Level of control (HA1C, BG)
  • Self Monitoring?
  • Medications
  • Vision Fluctuation?
  • Who is the patients doctor following the condition?

The (Very Basic) Process of Diabetic Retinopathy

Insulin problem –> High blood glucose level –> Loss of Pericytes –> Capillaries not supported vessel walls weaken –> microaneurysms –> Blood leakage –> Capillary non‐profusion –> Ischemia –> Macular Edema and Neovascularization

High blood glucose –> Vessel walls thicken –> Lumens get smaller –> Blood is also getting thicker and stickier

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