Perspective from Kyle Sandberg, OD, FAAO
Source/Disclosures
Source:

Hainsworth DP, et al. Diabetes Care. 2019;doi:org/10.2337/dc18-2308.

November 22, 2019
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HbA1c a major risk factor in retinopathy progression

Perspective from Kyle Sandberg, OD, FAAO
Source/Disclosures
Source:

Hainsworth DP, et al. Diabetes Care. 2019;doi:org/10.2337/dc18-2308.

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The strongest risk factor in the progression of retinopathy was mean HbA1c, according to findings presented in Diabetes Care.

The researchers also stated that elevated albumin excretion rate and diastolic blood pressure were modifiable risk factors associated with retinopathy progression.

Dean P. Hainsworth, MD, and colleagues sought to identify retinopathy risk factor outcomes in the context of a multicenter study with a well-characterized cohort of participants with type 1 diabetes after 30 years of follow-up.

The researchers examined the risks for proliferative diabetic retinopathy (PDR), clinically significant macular edema (CSME) and ocular surgery.

Hainsworth and colleagues found the rate of ocular events per 1,000 person years was 12 for participants with PDR, 14.5 for CSME and 7.6 in ocular surgery. Sixty-five percent of the participants remained free of PDR, 70% were free of CSME, and 75% remained free of ocular surgery.

The researchers wrote that the greatest risk factors for PDR, in descending order, were higher mean HbA1c, longer duration of type 1 diabetes, elevated excretion rate and higher mean diastolic blood pressure (BP). Risk factors for CSME were higher mean HbA1c, longer duration of type 1 diabetes and greater age and diastolic BP.

In ocular surgeries, risk factors included higher mean HbA1c, older ag, and longer duration of type 1 diabetes, Hainsworth and colleagues wrote.

“The general principles derived from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study most likely apply to current patients with [type 1 diabetes], but the higher rate of overweight and obesity in current patients may lead to additional risk factors,” Hainsworth and colleagues wrote. – by Earl Holland Jr.


Disclosures: The authors report no relevant financial disclosures.