Correlation between Diabetic Retinopathy Severity and Diabetic Foot Disease in Patients with Type 2 Diabetes Mellitus

Abstract

Background: Diabetic retinopathy (DR) and diabetic foot disease are important complications of longstanding type 2 diabetes mellitus (T2DM). Both are associated with chronic hyperglycaemia, microvascular dysfunction and cumulative diabetic tissue injury. This study evaluated the relationship between DR severity and diabetic foot disease in patients with T2DM.

Methods: A hospital-based cross-sectional study was conducted among 90 patients with T2DM of more than five years' duration and established diabetic foot disease. Demographic and clinical characteristics, duration of diabetes, glycaemic parameters and best-corrected visual acuity (BCVA) were recorded. Detailed ophthalmological examination was performed, and DR was graded according to the Early Treatment Diabetic Retinopathy Study classification. Diabetic foot disease was assessed clinically according to its severity. Appropriate statistical tests, including chi-square/Fisher's exact test, independent t-test and analysis of variance, were used, with p < 0.05 considered statistically significant.

Results: The mean age of participants was 54.63 ± 7.97 years, and 66 (73.3%) were male. The mean duration of diabetes was 16.03 ± 7.24 years, while mean BCVA was 0.633 ± 0.614 logMAR. Diabetic retinopathy was frequently observed, with NPDR being more common than PDR. Increasing severity of DR was significantly associated with greater severity of diabetic foot disease. Patients with more advanced retinal disease also demonstrated longer duration of diabetes and poorer glycaemic control. Visual acuity progressively deteriorated with increasing severity of DR.

Conclusion: Greater severity of diabetic retinopathy is associated with more advanced diabetic foot disease in patients with T2DM. This relationship may reflect the cumulative effects of longstanding diabetes, poor glycaemic control and shared microvascular and neurological mechanisms. Routine retinal evaluation in patients with diabetic foot disease and systematic foot assessment in those with advanced DR may facilitate early recognition of multisystem diabetic complications and support comprehensive multidisciplinary management.