Fasting plasma glucose variability is an independent risk factor for diabetic retinopathy and diabetic macular oedema in type 2 diabetes: An 8-year prospective cohort study
Journal
Clinical and Experimental Ophthalmology
Journal Volume
48
Journal Issue
4
Date Issued
2020-05-01
Author(s)
Hsieh, Ming Chia
Abstract
Importance: Long-term stability in plasma glucose may affect the development of diabetic retinopathy (DR) and diabetic macular oedema (DMO). Background: To investigate the associations between glycaemic variability and the development of DR and DMO in type 2 diabetes (T2D). Design: An 8-year prospective cohort study. Participants: 2005 patients with T2D. Methods: DR and DMO were detected with non-mydriatic fundus photography. Main outcome measures: The visit-to-visit variability of fasting glucose or HbA1c was calculated as the standard deviation (SD) or coefficient of variation (CV = SD/mean) of all records during the follow-up periods or before the onset of the targeted event. Cox regression analysis was used to evaluate the hazard ratios (HRs) for new-onset DR, proliferative diabetic retinopathy (PDR), and DMO. Results: After adjusting for the baseline and mean follow-up values, the SD and CV of fasting glucose during the follow-up periods were both correlated with the development of PDR (SD: HR = 1.011, P =.005; CV: HR = 6.858, P <.001), and DMO (SD: HR = 1.008, P =.038; CV: HR = 4.027, P =.017). As for HbA1c, neither the SD nor CV was correlated with the development of DR, PDR, or DMO (P >.05 for all). Conclusions and relevance: High visit-to-visit fasting glucose variability was associated with new-onset PDR and DMO, independent of baseline and mean follow-up fasting glucose and HbA1c in T2D. Long-term stability in plasma glucose is important for reducing the risk of the development and progression for DR and DMO.
Subjects
diabetes mellitus | diabetic macular oedema | diabetic retinopathy | glycaemic variability
SDGs
Type
journal article