Diabetic retinopathy is an abnormality of the microvasculature of the retina that occurs to almost all patients with chronic diabetes mellitus.
It is one of the leading cause of blindness worldwide and principal cause of impaired vision in patients aged 25-75 years of age.
The abnormality causes microaneurysms, retinal hemorrhages, lipid exudates, macular edema & neovascular vessel growth that may lead to blindness.
Educate patients on how to recognize visual symptoms (eg vision changes, floaters, distortion, redness, pain) that could be manifestations of disease progression & consult their ophthalmologist immediately when they occur
Advise DM patients to
Have strict glycemic control as risk of developing DR at 10 yrs is higher in those w/ FBS of 10 mg/dL & HbA1c >7%
Be compliant w/ anti-hypertensive drugs to maintain blood pressure systolic BP <130 mmHg
Control serum lipid levels w/ proper diet & to prescribed antidyslipidemic medications
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.