Título / Title

GLYCATED HEMOGLOBIN VARIABILITY PREDICTS DIABETIC RETINOPATHY IN PATIENT WITH TYPE 2 DIABETES: RESULTS FROM THE BRAZILIAN DIABETES STUDY

Introdução / Purpose

Background Diabetic retinopathy (DR) is the leading cause of blindness in working-age patients. Although prior studies revealed hyperglycemia as an imperative marker of diabetic retinopathy risk, whether glycemic variability imposes an increased risk of retinopathy stays unanswered. As retinopathy is often diagnosed at later stages, when the potential benefit of intervention is significantly attenuated, assessing glycemic variability as an added source when selecting diabetes patients for earlier referral to ophthalmological evaluation may assist in preventing disability. To assess this hypothesis, this study investigated the relationship between glycemic variability parameters and diabetes retinopathy using data from a local cohort of type 2 diabetes.

Material e Método / Methods

Basic procedures This study included cohort members aged 18 and up who had undergone an ophthalmological examination, including retinography and visual acuity testing, and who had at least two glycemic hemoglobin measurements throughout their participation in the study. The Early Treatment Diabetic Retinopathy Study (ETDRS) criteria were used to classify diabetic retinopathy. Using validated methods, glycemic variability was calculated as the standard deviation and mean amplitude of glycemic excursions.

Resultados / Results

Main findings In the studied population, 22% of individuals with T2DM had DR. Each 1% increase in baseline HbA1c was related to a 44% higher risk of diabetic retinopathy (OR 1.44, 95% CI 1.190–1.754, p 0.001. Each unit increase in HbA1c standard deviation was associated with a 74% increased risk of DR (OR 1.74, 95% CI 1.067–2.847, p 0.027).

Discussão e Conclusões / Conclusion

Principal conclusions Glycated hemoglobin variability, as standard deviation of repeated measures, was independently related to diabetic retinopathy risk.

Palavras Chave

Diabetic retinopathy; type 2 diabetes; Glycated hemoglobin, Glycemic Control.

Area

CLINICAL RETINA

Institutions

Universidade Estadual de Campinas - UNICAMP - Campinas - São Paulo - Brasil

Authors

DANIEL CAMPOS JESUS, JOAQUIM BARRETO, FERNANDO R. P. CHAVES, MATHEUS S. GASPARINI, VICENTE HIDALGO RODRIGUES FERNANDES, ANDREI CARVALHO SPOSITO