THE PREVALENCE OF CAUSES FOR DIABETIC RETINOPATHY USING MATHEMATICAL MODELS

International Journal of Advanced Research in Engineering and Technology (IJARET) Volume 9, Issue 6, November-December 2018, pp. 167 171, Article ID: IJARET_09_06_017 Available online at http://www.iaeme.com/ijaret/issues.asp?jtype=ijaret&vtype=9&itype=6 ISSN Print: 0976-6480 and ISSN Online: 0976-6499 IAEME Publication THE PREVALENCE OF CAUSES FOR DIABETIC RETINOPATHY USING MATHEMATICAL MODELS T. Subhramaniyan, P. Sankar Department of Mathematics, Guru Nanak College, Chennai, India P. Paulraj Department of Mathematics, A.M. Jain College, Chennai, India M. G. Ragunathan, J. Jayanthi Department of Advanced Zoology and Biotechnology, Guru Nanak College, Chennai, India ABSTRACT Diabetes mellitus is one of the non-communicable diseases which have become a majorglobal health problem all over the world. Diabetes interferes with the body's ability to use and store sugar (glucose). The disease is characterized by too much sugar in the blood, which can cause damage throughout the body, including the eyes which lead to progressive damage to the retina; it is a serious sight-threatening complication of diabetes. Diabetes causes retinal tissue to swell, resulting in cloudy or blurred vision. The condition usually affects both eyes. If left untreated, it may lead to loss of vision. The incidence and prevalence of diabetic retinopathy are on the increase in number globally. In this paper Mathematical Models are used to analyse and predict the prevalence of causes for diabetic retinopathy. This study reveals the efficiency of mathematical models and cost effective strategies to identify the prevalence of causes for diabetic retinopathy in the diabetic community. Key words: Mathematical Models, diabetic retinopathy. Cite this Article: T. Subhramaniyan, P. Sankar, P. Paulraj, M. G. Ragunathan and J. Jayanthi, The Prevalence of Causes For Diabetic Retinopathy Using Mathematical Models, International Journal of Advanced Research in Engineering and Technology, 9(6), 2018, pp 167 171. http://www.iaeme.com/ijaret/issues.asp?jtype=ijaret&vtype=9&itype=6 1. INTRODUCTION Diabetic Retinopathy (DR) is one of the complications occurring in Diabetes mellitus. Diabetes is two types called type 1 and type2.dr is most commonly occurring in T2DM.It is one of the global leading epidemic disease which linked to chronic increased blood sugar level due to insulin resistance (1).According to World Health organisation survey type 2 http://www.iaeme.com/ijaret/index.asp 167 editor@iaeme.com

T. Subhramaniyan, P. Sankar, P. Paulraj, M. G. Ragunathan and J. Jayanthi Diabetic prevalence is more than 200 million in next decade (2).In India Diabetic population till now 31.7 million and it may increase to expected ratio up to 79.4 million in the year 2030 (3). Globally Indians are most vulnerable to prevalence of this disease with 7.1% of our population (4) DR causes Progressive damage to retina and also posterior of the eye its affects the light sensitive lining. DR is one of the vision threatening complications of diabetes it interferes the usage of blood sugar level of body abilities (5). It develops variety of factors, duration of diabetes, uncontrolled sugar level and hypertension (6). It affects all parts of body especially it affects the eye in chronic stage of diseases. DR affects the small blood vessels this may lead to bleeding of blood and other fluids because of this swelling of retinal tissues takes place results in cloudy and blurred vision affects the both eyes.if untreated cause blindness (7).Despite the consequences of this problem, and its prevalence of diabetes in India, very few precise models are available till now to identify the causes for prevalence of DR and very few studies are published till now. We aim to estimate the prevalence of causes of DR and to find its connection with age, gender and the effect of duration of diabetes on the severity of DR among diabetic population using mathematical models. 2. METHODS AND MATERIALS A observation population based study, a cross sectional evaluation of prevalence of DR by using database, collected and maintained by Mohan Diabetics Centre, Chennai, we got prior approval and clearance to use this data for this study. From this data we consider the influencing factors like OCT values, age, gender, duration of diabetes, HbA1c,and hypertension, the analysis were done by using SPSS 23.0 version the test carried out in this study ANOVA test was used for goodness of fit of the model, multiple regression analysis approach was used for the prediction of DR in an individual and p value < 0.05 DR have been computed. For the Multiple Regression Analysis approach we take, = Value (in μm) is considered as the dependent variable. The following are the independent variables: 1. Age ( ) in years 1, 2. Gender ( ) = 0, 3. HbA1c (glycosylated hemoglobin) ( ) in % 4. Duration of Diabetics ( )in years 5. Triglyceride ( ) in / 6. HDL ( ) in / 1,!"# h% &'! 7. Family History ( ) = 0," h&' 1, #'"! h hh )"" 8. Hypertension( ( ) = 0," h&' 9. LDL ( * ) in / Example: For a given person the values of the different independent variables are: +, = 148.840, = 1.035, = 1.387, = 13.631, = 0.787, = 1.750, ( = 33.831, * = 1.027 http://www.iaeme.com/ijaret/index.asp 168 editor@iaeme.com

The Prevalence of Causes For Diabetic Retinopathy Using Mathematical Models The line of regression is given by = +, + + + + + + + + + + + + ( ( + + * * (1) Therefore, the equation (1) becomes = 148.840 + 1.035(75) + 1.387(11.3) + 13.631(10) + 0.787(75) + 1.750(1) + 33.831(1) + 1.027(54) = 148.840 + 77.625 + 15.673 + 136.31 + 59.025 + 1.750 + 33.831 + 55.458 = 528.51 8 In above the example, for an individual, the thickness of macular edema was found to be 528.51 8. Regression Statistics Multiple R 0.3366 R Square 0.1133 Adjusted R Square 0.05663 Standard Error 98.4803 Observations 184 ANOVA df SS MS F Significance F Regression 11 213227.593 19384.33 1.9987 0.031136 Residual 172 1668120.124 9698.373 Total 183 1881347.717 Coeff Std Error t Stat P-value Lower 95% Upper 95% Intercept 156.971571 67.46298488 2.326781 0.02114 23.809612 290.13353 Age 0.00242739 0.822466393 0.002951 0.99764-1.62099967 1.6258544 sex 54.4092627 17.35003803 3.135974 0.00201 20.1628525 88.655672 duration 0.43397890 0.791652816 0.548193 0.58426-1.12862671 1.9965845 father -26.021786 15.81320311-1.64557 0.10167-57.2347114 5.1911391 sibling 20.8260175 14.77764755 1.409292 0.16055-8.34287409 49.994909 smoking 9.93513131 19.73683759 0.50338 0.61534-29.0224683 48.892731 alcohol -9.3552161 18.29768601-0.51128 0.60981-45.4721433 26.761711 tri 0.1409110 0.091552742 1.539125 0.12561-0.03980049 0.3216226 hdl 0.55085507 0.872249094 0.631534 0.52852-1.17083569 2.2725458 ldl 0.03329181 0.198738638 0.167516 0.86716-0.35898887 0.4255725 Hypertension -0.6985153 15.40931596-0.04533 0.96389-31.1142271 29.717196 3. DISCUSSION Diabetic Retinopathy (DR) is one of the life threatening complications which is developed from Diabetes. The etiology of DR has been investigated by several authors. The association between LDL cholesterol and severity of DR has been studied by T.L. Dornan et al (15). In this factors determining on diabetic retinopathy among diabetic patients using Ordinary least square method study, the variables such as optical coherence tomography (OCT) value, age, http://www.iaeme.com/ijaret/index.asp 169 editor@iaeme.com

T. Subhramaniyan, P. Sankar, P. Paulraj, M. G. Ragunathan and J. Jayanthi duration of diabetics, level of hyperglycemia (HbA1c), triglycerides, family history, hypertension, LDL play a significant (p<0.05) role except gender and HDL was not significant (p>0.05) in the occurrence of DR. The propensity to develop DR is lower in south India when compared to the other populations (16). Observations indicate an association of serum lipid level (LDL) with lipid in the retina (hard exudates) and visual loss. Thus, serum lipid level may be important in the management of DR. Most of patients 67 (33.50%) were affected by DR in the age-group of 51 60 years and followed by 61 (30.50%) were in the age-group of 61 70 years. In this study, the mean duration of diabetes was calculated as 15.32 ± 7.83 yrs (mean ± SD). Similar type of results has been shown that nearly 75 per cent of type II diabetes will develop DR after 15 years duration of diabetes as shown in the epidemiological study (17). Hence, the duration of DM is significant with the progression of macular edema. Some DR patients may develop vision loss from DME. Clinically significant macular edema (CSME) occurs if there is thickening of the retina involving the center of the retina (macula) or the area within 500 μm of it, if there are hard exudates at or within 500 μm of the center of the retina with thickening of the adjacent retina, or if there is a zone of retinal thickening one disk area or larger in size, any part of which is within one disk diameter of the center of the retina (18). This definition of CSME generally refers to the threshold level at which laser photocoagulation is carried out. However, it is important to appreciate that the majority of visual loss occurs when macular edema involves the center. 4. CONCLUSION DR will develops in Diabetes so in diabetic community awareness will create through Information Education and Communication (IEC) activity there by it reduces the loss of vision thereby it reduces the vision-threatening complications as well as the incidence of DR in India. As per the ophthalmologist advice, diabetic population wants to go for ophthalmological checkup periodically so that we can early identification of DR and they control themselves in the particular normal range and to protect them from the visionthreatening complications. From this study concluded the influencing factors of prevalence of cause for diabetic retinopathy, so that they can protect themselves from DR and it may reduce remarkably. REFERENCES [1] Diabetic Retinopathy: available on http://www.aoa.org/diabetic-retinopathy.xml [2] Klein BE. Overview of epidemiologic studies of diabetic retinopathy. Ophthalmic Epidemiol 2007;14:p179 183 [3] Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes, estimates for the year 2000 and projections for2030. Diabetes Care 2004; 27 : p1047-53. [4] Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res ClinPract2010;87: p4 14. [5] Yang W, Lu J, Weng J, et al.; China National Diabetes and Metabolic Disorders Study Group Prevalence of diabetes among menand women in China. N Engl J Med 2010;362:p1090 110. [6] Centers for Disease Control and Prevention (CDC): Blindness caused by diabetes- Massachusetts, 1987-1994. MMWR MorbMortal Wkly Rep1996, 45:p937-941. [7] Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: Estimates for the year 2000 and projections for2030. Diabetes Care2004, 27:p1047-1053. [8] Bamashmus MA, Gunaid AA, Khandekar RB: Diabetic retinopathy, visual impairment and ocular status among patients withdiabetes mellitus in Yemen: a hospital-based study. Indian J Ophthalmol 2009, 57:p293-298. http://www.iaeme.com/ijaret/index.asp 170 editor@iaeme.com

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