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
- Level of control (HA1C, BG)
- Self Monitoring?
- 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