EFFECTS OF GLYCEMIC VARIABILITY ON THE PROGRESSION OF DIABETIC RETINOPATHY AMONG PATIENTS WITH TYPE 2 DIABETES
Jae‐Yong Park, Je Hyung Hwang, Min Ji Kang, Ha Eun Sim, Jae Suk Kim, Kyung Soo Ko
Abstract
PURPOSE: To evaluate the effects of glycemic variability on the progression of diabetic retinopathy (DR) among individuals with Type 2 diabetes and to test the hypothesis that consistent glycemic control delays the progression of DR. METHODS: This retrospective study included 1,125 participants with a follow-up period of more than 5 years and more than 20 glucose laboratory test results. The hazard ratio of ≥3 steps of progression on the Early Treatment Diabetic Retinopathy Study person scale and progression to proliferative DR were assessed. RESULTS: An increase in the HbA1c SD was associated with a higher risk of ≥3 step progression (P < 0.001) and progression to proliferative DR (P < 0.001). Not only mean HbA1c, but also HbA1c SD was associated with a lower risk of ≥3 steps of progression (P < 0.001), and progression to proliferative DR (P < 0.001). CONCLUSION: Achievable and consistent glycemic control may contribute to the delay in DR progression. CLINICAL TRIAL REGISTRATION NUMBER: Institutional review board of Inje University (No. 202003014).