showed that every 1% reduction in glycated haemoglobin there was 25%
decrease in microvascular disease.eye complication decreased by 19%,nephropathy by 25% and improvement in vibration perception in diabetic neuropathy patients DCCT(Diabetes Control and Complications Trial)1983-1993,on 1441 volunteers with type 1 diabetes,showed that in intensive group with median HbA1C of 7.3%,the retinopathy was reduced by 76%,kidney disease by 50% and clinical neuropathy by 60% EDIC study(Epidemiology of Diabetes interventions and complications)continued from DCCT in 1993,showed that intensive blood glucose control reduces cardiovascular disease by 42% and non fatal heart attack,stroke,or death from CVS cause by 57% ADVANCE study(Action in Diabetes and vascular disease)2008-conducted in over 10,000 patients with type 2 diabetes,showed that an intensive strategy with conventional agents can achieve mean HbA1C level of 65%safely and reduce diabetic nephropathy by 20% and microalbimunuria by 30% CURES-Chennai Urban Rural Epidemiological study-conducted on 20,000 individuals in Madras showed that the prevalence of diabetic retinopathy increase from 8.1%(HbA1C level<6.9%)to 31.7%(HbA1C level>10.3% and risk factor for diabetic neuropathy and nephropathy was bad glycaemic control WESDR-Wisconsin Epidemologic study of diabetic retinopathy-2012:was done on 2100 population,the prevalence of retinopathy was 12% when HbA1c<7%,as compared to 40.7% when Hba1C levels >10% and increased risk of PDR A1CHEIVE study-done on 20,554 indian type2 DM patients showed that patients with mean HbA1C of 9.2% had a higher prevalence of neuropathy(24%),renal disease(21.%)eye disease(16%)-hence proving glycemic control is of high importance ETDRS study (Early treatment and Diabetic retinopathy)-done on 371 patients ,identified HbA1C as a most important risk factor for PDR Stockholm diabetes intervention study-done on 100patients showed with intensified treatment and decreased HbA1c,had fewer chances of diabetic complications According to a study conducted in Tamil nadu on 1414 volunteers,on Sight Threathening Diabetic Retinopathy (STDR) by Raman R et al the HbA1c value >8.0% was significantly related with STDR. In a screening programme, the cut-off value of HbA1c >8.0% provided a maximum yield of STDR In a study done by Jocelyn Eid Fares et al it was concluded Incipient nephropathy was present in 18 and absent in 99 patients. Mean HbA1C was significantly higher in nephropathy than in non-nephropathy patients A Italian multicentre study RIACE (renal insufficiency and cardiovascular events) concluded that In patients with type 2 diabetes, HbA1c variability affects (albuminuric) CKD more than average HbA1c
In a study conducted by Ishratkareem et al -The average concentration of
magnesium in groups I (diabetic without retinopathy), group II (diabetic with retinopathy), and group III (control) were measured as 2.13 0.32, 1.2 0.38 and 2.60 0.37 meq/l respectively and HbA1c of 7,10,and 4. Group I,group II and III were also compared with respect to glycosylated hemoglobin, blood glucose,triglyceride and cholesterol levels.
Harold W.DeValket.al.,in his prospective study involving 61 diabetic
patients,showed the association between plasma magnesium concentration and development or progression of retinopathy and have concluded that magnesium supplementation may help to reduce the development or progression of retinopathy
Hatwal A et al (1989) conducted a study in which Serum magnesium was
measured in 100 patients of type II diabetes mellitus (40 without retinopathy, 40 with non-proliferative and 20 with proliferative retinopathy) The serum magnesium levels were lower in diabetics than in controls, and the levels in diabetics with non-proliferative and proliferative retinopathy were significantly lower than in those without retinopathy
In an observational study, done by Sakaguchi et al we found that
hypomagnesemia was significantly associated with progression to ESRD in patients with type 2 diabetic nephropathy but not in those with nondiabetic CKD.
In a comparative study that involved 30 patients who had type 2 diabetes
without microalbuminuria, 30 with microalbuminuria, and 30 with overt proteinuria,Corsonello et al. observed a significant decrease in serum ionized Mg in both the microalbuminuria and overt proteinuria groups compared with the nonmicroalbuminuric group.
Aradhana Sharma, et al(2007) conducted across-sectional study to
examine the relationship between serum magnesium in 50 type 1 and type 2 diabetic patients with or without complications and 40 normal healthy personsThere was strong association between hypomagnesaemia and retinopathy