Retino-Renal Dissociation in Type 2 Diabetes Mellitus

Diabetes induced retinopathy mostly proceeds nephropathy in patients with Type1 diabetes; however, this sequence is not consistent in patients with Type 2 diabetes and has significant discordance. An Observational Cross Sectional Study published in Journal of the Associations of Physicians of India found a relationship between retinopathy and nephropathy in type 2 diabetic patients.

It was seen that  Patients with type 2 diabetes do not have diabetic nephropathy always. It was a hospital-based prospective, was conducted at Indira Gandhi Medical College, Shimla. 141 patients with type 2 diabetes, 83 males,58 females were recruited in the study.

The Mean HbA1C was study was 9.

 56.0% patients in the study had HbA1C more than 9.0%

 27.7% had HbA1C between 7.0- 9.0%

 16.3% patients had HbA1C less than 7.0%.

Out of a total of 141 patients,      

Diabetic Kidney Disease was present in 47.52% patients and 33 had diabetic retinopathy. Hence it was recorded that  The relationship between retinopathy and nephropathy in type 2 diabetic patients is not as clear as in type 1 diabetic patients. Patients with type 2 diabetes do not have diabetic nephropathy always and non-diabetic renal disease is also quite common. The absence of retinopathy, rapid progression diabetes, presence of RBC, are some of the atypical findings, and patients presenting with them should be subjected to renal biopsy to rule out non-diabetic renal disease.