The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials
Intensive glucose therapy can protect the retina of individuals with diabetes, but it is unknown if it provides the same protection to patients with different severity of diabetic retinopathy (DR). We finally included DR-related studies involving intensive glucose control with large sample size and...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2020/8765139 |
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| author | Yuqi Liu Juan Li Jinfang Ma Nanwei Tong |
| author_facet | Yuqi Liu Juan Li Jinfang Ma Nanwei Tong |
| author_sort | Yuqi Liu |
| collection | DOAJ |
| description | Intensive glucose therapy can protect the retina of individuals with diabetes, but it is unknown if it provides the same protection to patients with different severity of diabetic retinopathy (DR). We finally included DR-related studies involving intensive glucose control with large sample size and long follow-up time, including five large and high-quality randomized clinical trials (RCTs): DCCT, UKPDS, ACCORD, AdRem, and VADT. With DCCT as a reference, we supposed a DR severity threshold that is verified by other RCTs then. We found that individuals who have DR lesions that are equivalent to or less severe than moderate NPDR achieve benefits for the retina by intensive glycemic control. However, these are realized only if the HbA1c in type 1 or type 2 diabetic patients is reduced at least by 0.8% versus the control group or it is reduced to <7% and >3 years of intensive glucose control is required. If the severity of DR lesions is worse than moderate NPDR, intensive glycemic control may not bring benefits. |
| format | Article |
| id | doaj-art-3ed55ed110a3400db29952c4090c13b5 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-3ed55ed110a3400db29952c4090c13b52025-02-03T05:49:30ZengWileyJournal of Diabetes Research2314-67452314-67532020-01-01202010.1155/2020/87651398765139The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical TrialsYuqi Liu0Juan Li1Jinfang Ma2Nanwei Tong3Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, 610041 Sichuan, ChinaDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, 610041 Sichuan, ChinaDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, 610041 Sichuan, ChinaDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, 610041 Sichuan, ChinaIntensive glucose therapy can protect the retina of individuals with diabetes, but it is unknown if it provides the same protection to patients with different severity of diabetic retinopathy (DR). We finally included DR-related studies involving intensive glucose control with large sample size and long follow-up time, including five large and high-quality randomized clinical trials (RCTs): DCCT, UKPDS, ACCORD, AdRem, and VADT. With DCCT as a reference, we supposed a DR severity threshold that is verified by other RCTs then. We found that individuals who have DR lesions that are equivalent to or less severe than moderate NPDR achieve benefits for the retina by intensive glycemic control. However, these are realized only if the HbA1c in type 1 or type 2 diabetic patients is reduced at least by 0.8% versus the control group or it is reduced to <7% and >3 years of intensive glucose control is required. If the severity of DR lesions is worse than moderate NPDR, intensive glycemic control may not bring benefits.http://dx.doi.org/10.1155/2020/8765139 |
| spellingShingle | Yuqi Liu Juan Li Jinfang Ma Nanwei Tong The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials Journal of Diabetes Research |
| title | The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials |
| title_full | The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials |
| title_fullStr | The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials |
| title_full_unstemmed | The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials |
| title_short | The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials |
| title_sort | threshold of the severity of diabetic retinopathy below which intensive glycemic control is beneficial in diabetic patients estimation using data from large randomized clinical trials |
| url | http://dx.doi.org/10.1155/2020/8765139 |
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