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

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. K E Y W O R D Sdiabetes mellitus, diabetic macular oedema, diabetic retinopathy, glycaemic variability

The risk for developing vision‐threatening retinopathy after cataract surgery in diabetic patients depends on the postoperative follow‐up time

“…2017) and is similar to the risk pattern for developing DME independently of cataract surgery (Hove et al. 2006; Bek 2020b; Hsiah & Hsiah 2020).…”

Analysis of retinal and choroidal characteristics in patients with early diabetic retinopathy using WSS-OCTA

“…FBG was positively correlated with ORT of the mid-peripheral regions and negatively correlated with VD of part regions in the DCP layer. A number of reports suggested that FBG is an independent risk factor for the occurrence of DR ( 34 ). Elevated FBG in diabetic patients increases hemoglobin glycosylation and increased glycosylation of hemoglobin increases its affinity for oxygen, therefore, preventing its release at the tissue inducing hypoxia and oxidative stress (OS), which further leads to a decrease in VD ( 35 ).…”