Since retinopathy occurs at higher HbA1c levels in black people for a given level of average plasma glucose, strategies may be needed to individualize the interpretation of HbA1c measurements (Diabetic Medicine)
Diabetes News
Category: Ophthalmology
How to perform better intervention to prevent and control diabetic retinopathy among patients with type 2 diabetes: A meta-analysis of randomized controlled trials
We found that multifactorial interventions can significantly reduce the risk of developing DR and its progression among patients with type 2 diabetes. More importantly, we found all these multifactorial interventions contained individualization of targets and communication between health professionals and patients, suggesting ophthalmologists and diabetes health professionals should work together with patients to set more individualized targets while taking into account multiple factors so as to achieve optimal effect in DR prevention and control (Diabetes Research and Clinical Practice)
Angiopoietins in Diabetic Retinopathy: Current Understanding and Therapeutic Potential
The function of the Ang proteins in regulating blood vessel permeability and neovascularisation is discussed, and we also evaluate recent preclinical and clinical studies highlighting the potential benefits of modulating Ang signalling as a treatment for DR (Journal of Diabetes Research)
Oxidative Stress as the Main Target in Diabetic Retinopathy Pathophysiology
In this review, we propose oxidative stress as the focus point of this complication onset (Journal of Diabetes Research)
Vulnerabilities in diabetic eye screening for children and young people in England
There is limited direct communication between the services involved in diabetic eye care for CYP in England. This risks reducing the effectiveness of diabetic retinopathy screening. Similar vulnerabilities are likely to exist in other countries where retinopathy screening for CYP has been ‘bolted on’ to provision for adults (Pediatric Research)
Retinopathy Outcomes With Empagliflozin Versus Placebo in the EMPA-REG OUTCOME Trial
Empagliflozin also reduced the risk of a prespecified microvascular outcome (composite of time to first initiation of retinal photocoagulation, vitreous hemorrhage, diabetes-related blindness, or incident/worsening nephropathy) by 38% versus placebo (Diabetes Care)
The prevalence of retinopathy in patients with type 1 diabetes treated with education-based intensified insulin therapy and its association with parameters of glucose control
In type 1 diabetes EBIIT is associated with good diabetes control and a low prevalence of DR. The cumulative glucose exposure over time given as HbA1c years is the best predictor for development of DR (Diabetes Research and Clinical Practice)
Applicability of telemedicine in the screening of diabetic retinopathy (DR): The first multicentre study in Italy. The No Blind Study
Our findings, in an Italian setting, confirm main data in the literature about DR prevalence. Hence, telemedicine could represent an accurate, fast and cheap method for screening of DR (Diabetes/Metabolism Research and Reviews)
Anti‐vascular endothelial growth factor for diabetic macular oedema: a network meta‐analysis
Anti‐VEGF drugs are effective at improving vision in people with DMO with three to four in every 10 people likely to experience an improvement of 3 or more lines VA at one year (Cochrane Database of Systematic Reviews)
Association between diabetic eye disease and other complications of diabetes: implications for care. A systematic review
This analysis highlights the need for a coordinated and collaborative approach to patient management. Given the widespread use of DR screening programs that can be performed outside of an ophthalmology office, and the overall cost‐effectiveness of DR screening, the presence and severity of DR can act as a means of identifying patients at increased risk for micro‐ and macro‐vascular complications, enabling earlier detection, referral, and intervention with the aim of reducing morbidity and mortality among patients with diabetes (Diabetes, Obesity and Metabolism)
Longitudinal relationship between retinal diabetic neurodegeneration and progression of diabetic retinopathy in patients with type 2 diabetes
Progressive loss of mGCIPL is an independent risk factor for progression in early-stage DR. Further assessment of autonomic and peripheral nerve functions can increase sensitivity in predicting aggravation of DR in patients with T2DM (American Journal of Ophthalmology)
Global perspectives on the provision of diabetic retinopathy screening and treatment: Survey of health care professionals in 41 countries
Health care professionals need to be appropriately supported and trained so they can provide adults with diabetes with information about the risks of DR, support them in reducing their risk, and advocate for the provision of affordable DR screening and treatment as required (Diabetes Research and Clinical Practice)
Lipid‐lowering medication is associated with decreased risk of diabetic retinopathy and the need for treatment in patients with type 2 diabetes
In a population of patients with type 2 diabetes with a variety of risk profiles, use of lipid‐lowering medication reduced the risk of DR and thus the risks involved in treatment with laser photocoagulation and vitrectomy (Diabetes, Obesity and Metabolism)
Confocal microscopy of corneal nerve plexus as an early marker of eye involvement in patients with type 2 diabetes
CNL and CNT changes are evident even in the early stages of DM, and RNFL reduction was recorded in the temporal quadrants. These findings indicate that, in the eye with diabetes, neuropathy may represent an early marker of the disease (Diabetes Research and Clinical Practice)
Association of Metformin Treatment with Reduced Severity of Diabetic Retinopathy in Type 2 Diabetic Patients
Long-term use of metformin is independently associated with a significant lower rate of SNPDR/PDR in patients with type 2 diabetes ≥ 15 years (Journal of Diabetes Research)
Optimal cutoff values of fasting plasma glucose (FPG) variability for detecting retinopathy and the threshold of FPG levels for predicting the risk of retinopathy in type 2 diabetes
Our study provides new cutoff values for FPG variability. Cutoff values of FPG and HbA1c were slightly higher than recommended targets of the current guideline. The threshold of FPG levels (6.9 mmol/L) is proposed to predict retinopathy incidence during the subsequent 25 years (Diabetes Research and Clinical Practice)
Association of Abnormal Renal Profiles and Proliferative Diabetic Retinopathy and Diabetic Macular Edema in an Asian Population With Type 2 Diabetes
Abnormal renal profiles at baseline, including a high serum creatinine level, low estimated glomerular filtration rate, and high urinary ACR, were associated with the development of PDR in patients with type 2 diabetes (JAMA Ophthalmology)
The UK Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group, Report 2: real-world data for the impact of cataract surgery on diabetic macular oedema
This large real-world study demonstrates that the rate of developing treatment-requiring DMO increases sharply in the year after cataract surgery for all grades of retinopathy, peaking in the 3–6 months’ postoperative period. Patients with moderate and severe NPDR are at particularly high risk (British Journal of Ophthalmology)
Mechanism of worsening diabetic retinopathy with rapid lowering of blood glucose: the synergistic hypothesis
We postulate that exogenous insulin could act synergistically with the vascular endothelial growth factor expressed by ischemic retina so as to trigger vascular proliferation and the worsening of diabetes retinopathy (BMC Endocrine Disorders)
Differences in incidence of diabetic retinopathy between type 1 and 2 diabetes mellitus: a nine-year follow-up study
The incidence of any-DR and STDR was higher in patients with T1DM than those with T2DM. Also, the 47.26% sum incidence of any-DR in patients with T1DM was higher than in a previous study (35.9%), which can be linked to poor metabolic control of DM. Our results suggest that physicians should be encouraged to pay greater attention to treatment protocols for T1DM in patients (British Journal of Ophthalmology)
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