الفهرس 
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Abstract
This study was carried out on 70 type II diabetic patients their ages ranged from 30 - 65 years and a control group of 20 apparently normal healthy subjects matched for age and sex.The patients were selected from Outpatient Clinics of Medicine and Ophthalmology Departments of AI-Minya University Hospital.Subjects were divided into 3 groups: Group I: -Twenty nonnal healthy subjects, their ages ranged fron1 30 to 63 years with mean + SD 40.7 + 12.7 .- Group II: Thirty five patients with type II diabetes mellitus their fundus eXa111ination was free ,their ages ranged from 33 to 65 years with mean + SD 51.2 + 8.4 and the duration of diabetes ranged from 1 to 12 years. - Group III: Thirty five patients with type II diabetes mellitus their fundus examination showed diabetic retinopathy, their ages ranged from 40 to 65 years with mean + SD 53.0 + 7.5 and the duration of diabetes ranged. from 9 to 30 years, this group is subdivided according to severity into three subgroups: - Subgroup A: Non proliferative retinopathy. - Subgroup B : Macular odaema. -Subgroup c : Proliferative retinopathy.
The aims of the study are:
1- Evaluation of serum levels of SlCAM-I, Svcam-I and selecting in type II diabetic patients with diabetic retinopathy and correlate their levels with other biochemical parameters.
2-evaluation of the role of s ICAM-I, s VCAM-I and selecting as one of the possible mechanisms of diabetic retinopathy.
3- Increased levels of circuiting forms of s VCAM-I, Slcam-I,sE-selectin are closely associated with the presence of vascular complications in diabetic patients and hence can be used as a circulating marker for the presence of such complications.
4- Microalbuminuria is a reliable marker of diabetic retinopathy and high level may serve as an indicator of proliferate diabetic retinopathy
5- Funds examination for diabetic patients at least annually.
Conclusions:
Good glycaemia control is very important factor in preventing or decreasing diabetes complications.
Good control of lipids is very important factor in preventing or decreasing diabetes complications.
Regular screening for microalbuminuria with appropriate medical management can reduce the risk of blindness.
Measurements of s VCAM-I, Sicam-I selecting levels in diabetic patients may be clinically useful for assessing diabetic retinopathy and may serve as a marker of inflammation.
Lt is hypothesized that serial s VCAM-I,Sicam-I selecting and microalbuminuria levels could be of benefit in identifying patients at high risk for the development of clinically apparent vascular complications (Schmidt et al.,1995).lt might provide surrogate maker for assessment of therapy designed to attenuate the progression of vascular disease and might become target molecules to fight vascular diabetic complications.