Long-term blood glucose control can reduce diabetic retinopathy progression

Jack Woodfield
Mon, 13 Jun 2016
Long-term blood glucose control can reduce diabetic retinopathy progression
People with type 2 diabetes who have well-controlled blood sugar levels can cut their risk of diabetic retinopathy progression, a study reports.

These findings were from the ACCORDION trial, a follow-up assessment of 1,310 people with type 2 diabetes who had diabetic retinopathy and participated in the ACCORD trial.

The ACCORD trial tested three treatment strategies to reduce patients' risk of developing cardiovascular disease: maintaining good glycemic control, improving cholesterol levels, and lowering blood pressure.

Four years later, progression of diabetic retinopathy was assessed among those required to keep good blood glucose levels. Patients who had received intensive blood glucose therapy, on average, had greater reductions in HbA1c than those on standard therapy, and the researchers made another significant finding.

While keeping good glycemic control failed to reduce the risk of cardiovascular disease, retinopathy progression had been cut by roughly one-third at the end of the ACCORD trial.

The ACCORDION trial re-assessed these patients four years afterwards. HbA1c levels were practically identical in both groups, respectively; diabetic retinopathy had advanced in only 5.8 per cent of those in the intensive therapy group, compared to 12.7 per cent in the standard therapy group.

Lead author Emily Chew, M.D., deputy director of the NEI Division of Epidemiology and Clinical Applications, said: "This study sends a powerful message to people with type 2 diabetes who worry about losing vision. Well-controlled glycemia, or blood sugar level, has a positive, measurable, and lasting effect on eye health."

"Despite this equalisation of glycemic control in the two groups, there continued to be an approximately 50 per cent risk reduction of further retinopathy progression, a phenomenon termed metabolic memory," added Frederick L. Ferris III, M.D., National Institutes of Health's National Eye Institute (NEI) clinical director, who was not involved in the study.

The findings appear in Diabetes Care.
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