Publication:

Assessing the risk of heart failure in patients with diabetic retinopathy with type 2 diabetes mellitus

Background Type 2 diabetes mellitus (T2DM) is associated with both microvascular and macrovascular complications, notably diabetic retinopathy (DR) and heart failure (HF), respectively. While DR is a well-established marker of retinal microangiopathy, emerging evidence suggests it may also reflect systemic vascular pathology. However, data on this association in the Indian population remains limited.

Methods A hospital-based cross-sectional observational study was conducted at GSVMMC, Kanpur, between August 2023 and February 2025. Ninety-two adults with T2DM were enrolled and assessed for DR using fundoscopic examination and graded from 0 to 3. Heart failure was diagnosed and classified via echocardiography into HFpEF, HFmrEF, and HFrEF. Biochemical markers, including HbA1c and NT-proBNP, were evaluated. Statistical analysis included Chi-square tests and ANOVA using statistical package for the social sciences (SPSS) v20.

Results Among the 92 patients, 73 (79.34%) had some form of heart failure, and 74 (80.43%) had DR. A significant association was found between DR and HF (p=0.001). The prevalence of HFrEF increased with DR severity from 10% in grade 0 to 35% in grade 3 DR (p=0.045). Additionally, poor glycemic control and higher body mass index (BMI) were common in patients with more severe DR and HF.

Conclusion DR is significantly associated with both the presence and severity of HF in T2DM patients. Retinal examination may serve as a practical, non-invasive tool for early cardiovascular risk stratification. These findings support integrated screening strategies in diabetic care.