Background White blood cells, particularly neutrophils and lymphocytes, may be a possible inflammatory marker since they are important in regulating the inflammatory response. The present study was conducted with an aim to compare the NLR in diabetics with and without retinopathy, and its severity. Methods The present case control study was conducted at department of General Medicine, Krishna Rajendra hospital, Mysore during the study period from August to November 2024 among 80 type II diabetes patients. The patients were divided into two groups of 40 patients in each on the basis of retinopathy present or absent. All the necessary laboratory investigations were done and results were analyzed using SPSS version 25.0. Results The value of mean HbA1c in diabetic retinopathy group was 10.0±2.0 and in without diabetic retinopathy group was 8.9±1.4 and results were significant with p value 0.005. The value of mean fasting blood sugar was 126.7±24.0 in diabetic retinopathy group and it was 133±20.4 in non diabetic retinopathy group. Mean PPBS was 216.8±48.6 in diabetic retinopathy group and 196.9±34.4 in non diabetic retinopathy group and results were significant with p value 0.038. Parameters like WBC, neutrophils and NLR were significantly (p<0.05) higher in patients with diabetes retinopathy. Out of 40 patients 5 (12.5%) had proliferative diabetic retinopathy (PDR) and 35 (87.5%) had non proliferative diabetic retinopathy (NPDR). Out of 35 patients with NPDR 9 (22.5%) were had mild level, 17 (42.5%) had moderate level and Page | 37 severe level 14 (35%). Association of various parameters (laboratory) with severity of diseases in NPDR patients showed no significant association (p>0.05) between them with NLR higher in severe group. On comparison statistically significant association was found between two groups on the basis of HbA1C with p value 0.000. Conclusion When evaluating diabetic retinopathy in patients with type 2 diabetes mellitus, NLR, an effective and reliable indicator of inflammation, can be a significant predictor.

biomarker, diabetes mellitus, diabetes retinopathy, inflammation, neutrophil lymphocyte ratio.