Diabetic Retinopathy-A Review.

Diabetic Retinopathy is a vascular microvascular disease also called diabetic eye disease caused by microangiopathy leading to progressive damage of the retina and blindness. The uncontrolled blood glycemic level or sugar level results in diabetic retinopathy. There are two stages of diabetic retinopathy: proliferative diabetic retinopathy and nonproliferative diabetic retinopathy. Symptoms of diabetic retinopathy often have no early warning signs, even muscular edema, which can cause rapid vision loss. Macular edema in which the blood vessels leak can also occur at any stage of diabetic retinopathy. Symptoms are darkened or distorted images and blurred vision that are not the same in both eyes. This review study primarily discusses the pathophysiology, genetics, and ALR, AGEs, VEGF, EPO, and eNOS involved in diabetic retinopathy. The longer a person has diabetes, the higher their risk of developing some ocular problems. During pregnancy, diabetic retinopathy may also be a problem for women with diabetes. NIH are recommends that all pregnant women with diabetes have an overall eye examination. Diagnosis of diabetic retinopathy is made during an eye examination that comprises ophthalmoscopy or fundus photography, and glow-in angiography for Fundus. Here, we present a review of the current insights into pathophysiology in diabetic retinopathy, as well as clinical treatments for diabetic retinopathy patients. Novel laboratory findings and related clinical trials are also analysed.

Serum Zinc and β D Glucuronidase Enzyme Level in Type 2 Diabetes Mellitus with Periodontitis.

The exact mechanism by which nutritional deficiency and lysosomal enzyme change, modify periodontal destruction has not yet been precisely defined. The study aimed to determine the serum zinc and ß D glucuronidase enzyme level in the selected groups and how its increase or decrease levels are related to type 2 diabetes mellitus (T2DM) with periodontitis when compared to other groups. Six hundred subjects were selected and are categorized into four groups as Group I (control healthy subjects, n=150), Group II (T2DM with periodontitis, n=150), Group III (T2DM without periodontitis, n=150) and Group IV (Non-DM with periodontitis, n=150). The lab investigations included measuring fasting blood glucose, serum zinc and ß D- glucuronidase levels. In the results, the level of serum zinc was found to be lesser in group III subjects and the activity of serum ß D glucuronidase was found to be elevated nine times in group III (T2DM with periodontitis) and two times elevated in group II (T2DM without periodontitis) and group IV (Non-DM with periodontitis), when compared to control. Zinc has been reported to reduce the stabilization of lysosomal membranes. Periodontitis has been taken as the prime condition in this study and categorized as experimental groups. Perturbations in mineral metabolism are more pronounced in diabetic populations. When the level of zinc is decreased, the structural integrity of lysosomal membrane has been lost and it would have caused for the increased release of ß D glucuronidase in T2DM with periodontitis.

High acid phosphatase level in the gingival tissues of periodontitis subjects.

AIM: Periodontitis is one of the major problems slowly progressing and could affect 70% of the global population. The prevalence of periodontitis differs from mild to moderate forms of race and geographic region. The aim of this study is to determine the acid phosphatase (ACP) activity in the gingival tissues of periodontitis subjects. In this study, the activity of ACP in the gingival tissue of subjects with periodontitis was examined. MATERIALS AND METHODS: A total of 30 subjects were selected for the study and are divided into group I (n = 15, healthy subjects in control) and in group II (n = 15, periodontitis subjects). The gingival tissue from group I and group II subjects were collected after the surgery and the ACP enzyme level was analyzed using ultraviolet spectrophotometer. Assessment of periodontitis was done based on periodontal probing depth (PPD) and clinical attachment level (CAL). The statistical analysis applied was independent sample t-test, P < 0.05 was considered as significant. RESULTS: The results of group II periodontitis subjects showed statistically significant increased gingival tissues ACP level when compared with the control group I subject. The mean levels of CAL and PPD were significantly >4 mm in periodontitis subjects when compared to control. CONCLUSIONS: The elevated level of ACP in the gingival tissue and Gram-negative microorganisms found in sub-gingival plaque was greater in periodontitis. Based on these results, gingival tissue ACP level can be considered as an independent risk factor for evaluating the microbial status and periodontal tissue damage.

Zinc and type 2 diabetes mellitus with periodontitis ­ a systematic review.

Diabetes mellitus has been increasing rapidly worldwide, making it a huge health pressure on society in both the developed and developing countries. During the last thirty years, diabetes mellitus, a chronic metabolic disease characterized by hyperglycemia is proving itself to be fatal. Periodontitis was considered as one of the main, oral health problems encountered in patients with diabetes mellitus. There exists a direct relation between the risk of complications of diabetes and periodontitis over time. The present review gives an outline of the features that govern the interrelationship between zinc and diabetes mellitus with periodontal disease, including the physiologic mechanisms and clinical studies, and presents scientific evidences. The disturbance in the zinc micronutrient and increased oxidative stress in type 2 diabetes may bring about insulin resistance and the creation of diabetic complications. The progression of diabetes mellitus may bring about perturbation in micronutrient metabolism and status.

Serum zinc and magnesium concentrations in type 2 diabetes mellitus with periodontitis.

AIM: The purpose of the study was to evaluate the serum levels of zinc (Zn) and magnesium (Mg) in type 2 diabetes mellitus (DM) with periodontitis patients and to correlate them with the levels of serum cholesterol, high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), and triglycerides among the study subjects. MATERIALS AND METHODS: A total of 600 subjects participated in the study, who were divided into four groups as control healthy individuals (group I), type 2 DM without periodontitis (group II), type 2 DM with periodontitis (group III), and periodontitis subjects without DM (group IV), matched for age, sex, and duration of diabetes. Serum concentrations of glucose, total cholesterol, triglycerides, HDL-c, Zn, and Mg were measured using enzymatic methods in an UV absorption spectrophotometer, and LDL-c was calculated using Friedwald's formula. Student's t-test, Pearson correlations, and analysis of variance (ANOVA) tests were used for statistical analysis. RESULTS: The serum zinc level was found to be significantly increased in type 2 DM without periodontitis (group II) and periodontitis subjects without type 2 DM (group IV) (P < 0.0001), and the level was lowered in type 2 DM with periodontitis (group III) when compared to control. The serum Mg level was found to be significantly decreased (P < 0.0001) in group II, group III, and in group IV, when compared to control. We found a significant increased level of serum total cholesterol and LDL-c and decreased triglycerides and HDL-c in type 2 DM subjects with periodontitis (group III, P < 0.0001). CONCLUSION: Patients with DM and periodontitis had altered metabolism of Zn and Mg which were linked to increased values of serum cholesterol and LDL-c and decreased HDL-c, contributing to the progression and complications of type 2 DM with periodontitis.