O impacto da alimentação na evolução do quadro clínico da retinopatia diabética: uma revisão integrativa.

Abstract

Diabetes mellitus can result from a lack of insulin or from the body's inability to use it properly. Type 1 diabetes mellitus is defined as the loss of insulin-producing pancreatic beta cells due to an interruption in their production mediated by an autoimmune action. Type 2 diabetes mellitus is a pathology in which affected individuals have peripheral resistance to insulin and a relative deficiency of this hormone. Diabetic retinopathy is linked to hyperglycemia, and this complication is considered the main cause of blindness in individuals of working age. It presents in two forms: non-proliferative diabetic retinopathy (NPDR), which has three asymptomatic stages: the mild stage with the presence of microaneurysms; the moderate stage with the presence of punctual hemorrhages; and the severe stage with intraretinal hemorrhages and the formation of venous beads. Proliferative diabetic retinopathy (PDR) is marked by neovascularization and presents symptoms such as the presence of black spots or bright lights in the field of vision. This study aimed to construct a synthesis of the most recent studies published in the world literature that addressed evidence on the impact of diet on the evolution of the clinical picture of diabetic retinopathy. This is an integrative literature review, where the following descriptors (DeCs) were used: “Diabetic retinopathy (no alternative term)”, “Diabetes mellitus/Diabetes mellitus” and “Diet/Food” to search for articles. With the inclusion criteria being a 5-year time frame, that is, from 2020 to 2025; English and Portuguese language; and availability of free access to the full text, 13 articles were selected to compose the final sample of the study. The themes addressed by the included works were: the relationship between diet and diabetic retinopathy, food and nutrient consumption in the clinical picture of diabetic retinopathy and the antioxidant effect of dietary components in diabetic retinopathy. Studies have indicated that healthy dietary patterns, with a predominance of anti-inflammatory foods, rich in fiber, antioxidants, vitamins, and beneficial fatty acids, were protective against the development of DR, while diets rich in saturated fat, ultra-processed foods, and refined carbohydrates were associated with an increased risk of DR.