The prevalence of diabetic retinopathy and associated risk factors among diabetic foot ulcer patients

Objectives: Diabetic foot ulcers (DFU) and diabetic retinopathy (DRP) are chronic and serious complications of diabetes that negatively affect quality of life, treatment costs and mortality risk in diabetics. Generally, DRP is associated with microvascular damage, whereas DFU is associated with both micro- and macrovascular damage. Many studies have identified DRP as a risk factor for the development of DFU and limb amputation. In contrast, very few studies have investigated the incidence of DRP and associated risk factors in DFU patients. Methods: The study group consisted of 85 patients with DFU, and the control group consisted of 81 diabetics without DFU. All patients underwent fundus examinations to determine the presence and stage of DRP. We recorded examination findings, demographic characteristics, associated comorbid conditions, and routine laboratory results of the patients, and compared them between groups. Results: DRP was detected in 73 patients (85.9%) in the study group and 42 patients (51.9%) in the control group (p <.001). As compared to the control group, the study group had a significantly higher rate of proliferative DRP (33.3% vs. 11.1%) (p=.002). Increased DM duration, advanced age, low GFR, and low hemoglobin values were associated with increased DRP frequency in the study group (p<.001, p=.002, p<.001 and p=.015, respectively). The frequency of DRP was also higher in patients suffering from hypertension, proteinuria, and coronary artery disease (p=.001, p=.001 and p=.002, respectively). Further, advanced stages of DFU were associated with an increased frequency and severity of DRP (p=.005). Conclusions: Early detection and treatment of DRP, which is quite common and has a progressive course in patients with DFU, will decrease the risk of serious morbidities and mortality associated with DRP. Keywords: diabetic foot ulcer, diabetic retinopathy, microvascular complication