Diabetes mellitus is a chronic metabolic disease characterised by persistent hyperglycaemia. The basic pathophysiology in DM begins with loss of capillary pericytes. These are cells found in the capillary walls, which act like a scaffold to support the wall. Their loss makes the capillaries weak and start to leak exudates. The breach in the capillary walls also makes platelets aggregate around the area increasing the risk of thromboembolism. Organs with small end-arterioles are most affected such as the brain, eyes, kidneys, heart, penis, limbs etc.
This explains why the long-term complications of DM include stroke, depression, diabetic retinopathy, renal failure, myocardial infarctions (heart attack), erectile dysfunction, amputations etc. Diabetic retinopathy occurs when the capillaries undergo occlusion and leakage. Retinal ischaemia results, prompting release of vascular endothelial growth factor which stimulates the growth of new vessels in an attempt to supply oxygen to the ischaemic areas.
Diabetic retinopathy (DR) is of growing concern to individuals and communities across the world. As the number of people living with diabetes continues to rise (and some patients are undiagnosed), the need for knowledge on this long term complication of diabetes becomes increasingly important.
Underpinning this course is the following core definition of diabetic retinopathy:Diabetic retinopathy is a serious, complex and progressive sight-threatening retinal disease that occurs exclusively in people living with diabetes. It results from damage to the retinal microvasculature resulting from persistent hyperglycaemia. It is the most common ocular and microvascular complication of diabetes.
The goal of this course is to equip us to delay onset and progression of DR, and prevent DR-related blindness. This means recognizing the risk factors of the disease, the likely course that the disease process will take, and what care we can give for patients with any stage of the disease.
© Nyawira Mwangi
Control of Diabetic Retinopathy 