Impact of smoking and environmental toxins on diabetic retinopathy: role of trace elements, lipid profiles, and vitamin A.

Diabetic retinopathy (DR), a leading cause of adult blindness, is influenced by physiological factors such as lipid profiles, vitamin A, and trace elements, as well as environmental factors like smoking. This study investigated the relationship between HbA1C, glucose levels, trace elements (lead, zinc, selenium, magnesium), vitamin A, and lipid profiles (TC, TG, HDL, LDL, VLDL) in type 2 diabetes (T2D) and DR patients, considering the impact of smoking. The study, conducted at Nasiriya General Hospital and the Center for Endocrinology and Diabetes (May 2023-March 2024), included three age groups (15-35, 35-55, and 55-75 years) divided into smokers and non-smokers. Results showed significantly higher glucose, HbA1C, lipid and selenium levels in T2D and DR patients compared to controls (p≤0.05), with smokers exhibiting greater lead levels. Zinc and vitamin A were significantly lower in DR patients, particularly among smokers. The findings highlight smoking as a source of lead and other toxins that exacerbate DR and diabetes-related complications, emphasizing the critical link between environmental health and chronic disease management.