Influence of metabolic dysregulation on the progression of diabetic retinopathy during pregnancy

Abstract

BACKGROUND. It is estimated that more than 530,000,000 people suffer from diabetes globally. In Mexico, it represents the second cause of death, with a prevalence close to 17%, representing approximately 14,600,000 people. The lack of control of diabetes in pregnancy has consequences at different organic and functional levels, causing alterations at the level of the micro and macrovasculature, at the ocular level could cause uveitis, glaucoma and diabetic retinopathy, with a strong association with the development of macular edema and cataracts. MATERIALS AND METHODS. Search the Medline database via PubMed using terms: "diabetic retinopathy", "mellitus diabetes", and "ophthalmological diseases". The search was limited to: "Case Reports", "Review", "Systematic Reviews", and "Books and Documents", "Spanish and English", editorials, reviews, duplicate articles were excluded, and 33 studies were selected that included pregnant diabetic women with the development of diabetic retinopathy, and other different ophthalmological complications. CONCLUSIONS. The hyperglycemic state is the major determinant for a more severe and rapid progression of DR. Although pregnancy itself is a state that causes alterations at the ophthalmological level, these are not severe, and generally return to normal in the puerperium, however, pregestational diabetes is one of the main causes of progression of diabetic retinopathy. Predisposing an important cause of presbyopia and blindness in early adulthood, hence the importance of achieving an optimal state of preconceptional health, or failing that, achieving an acceptable metabolic state during pregnancy.