Relationship between Glycemic Control and Diabetic Retinopathy

Yun, Woo Jun

Abstract

BACKGROUND
The prevalence of diabetes mellitus (DM) is higher in old age, and diabetic retinopathy is the leading cause of blindness. Appropriate glycemic control is known to reduce the incidence of diabetic retinopathy in diabetic patients. We evaluated the relationship between hemoglobin A1c levels and diabetic retinopathy.
METHODS
Our subjects included 654 diabetic patients registered with the public health center. Following an overnight fast, venous blood and urine samples were collected and analyzed. Non-mydriatic fundus photography was done to diagnosis diabetic retinopathy. We calculated the odds ratios of hemoglobin A1c and fasting plasma glucose for diabetic retinopathy using logistic regression.
RESULTS
Diabetic retinopathy was seen significantly more often at higher levels of hemoglobin A1c (odds ratio, 3.46; 95 % confidence interval, 1.90-6.30 for <50 percentile vs. >75 percentile). Fasting glucose, however, was not significantly associated with diabetic retinopathy after adjusting for hemoglobin A1c (Hb1cA). The odds ratio for diabetic retinopathy according to HbA1c was higher in those with DM for >10 years than <10 years.
CONCLUSION
The HbA1c level was significantly associated with diabetic retinopathy in Koreans with type 2 diabetes.