Impact of HbA1c followed 32 years from diagnosis of type 1 diabetes on development of severe retinopathy and nephropathy. The VISS-Study (original) (raw)
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Diabetes Care, 2014
HbA1c is strongly related to the development of diabetes complications, but it is still controversial which HbA1c level to strive for in the treatment of type 1 diabetes. The aim of the current study was to evaluate HbA1c, followed from diagnosis, as a predictor of severe microvascular complications and to formulate HbA1c target levels for treatment. A longitudinal observation study followed an unselected population of 451 patients diagnosed with type 1 diabetes during 1983-1987 before the age of 35 years in a region of Southeast Sweden. Retinopathy was evaluated by fundus photography and nephropathy data collected from medical records. HbA1c was measured starting from diagnosis and during the whole follow-up period of 20-24 years. Long-term weighted mean HbA1c was then calculated. Complications were analyzed in relation to HbA1c levels. The incidence of proliferative retinopathy and persistent macroalbuminuria increased sharply and occurred earlier with increasing long-term mean HbA1c. None of the 451 patients developed proliferative retinopathy or persistent macroalbuminuria below long-term weighted mean HbA1c 7.6% (60 mmol/mol); 51% of the patients with long-term mean HbA1c above 9.5% (80 mmol/mol) developed proliferative retinopathy and 23% persistent macroalbuminuria. Long-term weighted mean HbA1c, measured from diagnosis, is closely associated with the development of severe complications in type 1 diabetes. Keeping HbA1c below 7.6% (60 mmol/mol) as a treatment target seems to prevent proliferative retinopathy and persistent macroalbuminuria for up to 20 years.
Correlation between HbA1c Levels and Severity of Diabetic Retinopathy
DIPONEGORO MEDICAL JOURNAL (Jurnal Kedokteran Diponegoro)
Background: In recent years, Diabetes Mellitus (DM) has emerged as the world's leading cause of death with the potential to develop micro vascular complications in the form of retinopathy. HbA1c is an indicator to identify hyperglycemia and plays an important role in monitoring the development of complications due to DM. This study is undertaken determine the relationship between HbA1C levels and the severity of diabetic retinopathy in DM patients. Aim: To identify the relationship between HbA1c levels and different stages of diabetic retinopathy. Method: An analytic observational, cross sectional design, using patients’ medical record. Patient data consisted of gender, age, DM duration, HbA1c levels, and stages of diabetic retinopathy. Non parametric correlation Spearman’s rho was chosen for statistical analysis. Result: A total of 72 DM patients consisted of 29 men and 43 women with a mean DM duration 10.4 years. A total of 37 patients were diagnosed with diabetic retinopathy ...
Correlation between HbA1c and Diabetic Retinopathy in Type 2 Diabetes Mellitus
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Type 2 diabetes mellitus is now a common and a global health problem in both developed and developing country due to dietary change, reduced physical activities, increase urbanisation, increasing age and unhealthy life style. Risk of diabetic retinopathy increases with increase in duration and severity of hyperglycaemia. HbA1c is the important predictor for treatment and risk of developing microvascular and macrovascular complications. So, correlation between HbA1c and diabetic retinopathy in type 2 diabetes mellitus is depicted in our study. We wanted to study the relationship between HbA1c and diabetic retinopathy in type 2 diabetes mellitus and correlate the severity of diabetic retinopathy with increase in levels of HbA1c. METHODS It is an observational study done in tertiary care hospital from September 2018 to August 2019. 200 patients who were referred from endocrinology department for funduscopic examination having complaints of vision loss were enrolled in the study. Age, sex, duration of diabetes, FBS, PPBS, HbA1c value, and funduscopy findings were recorded. Patients were followed up for 3 months. RESULTS 200 patients were included in the study. 115 (57.5%) were male, 85 (42.5%) were female. Male:Female ratio was 1.35:1.80 (40%), had HbA1c value >14.5; 50 (25%) patients had 12.6-14.5; 38 (19%) patients had 10.6-12.5; 22 (11%) patients had 8.6-10.5; and 10 (5%) patients had 7-8.5. CONCLUSIONS Severity of diabetic retinopathy increases in patients with higher value of HbA1c. HbA1c is the predictor of severity of diabetic retinopathy.
Relationship between HbA1c Levels and Severity of Diabetic Retinopathy
Pakistan Journal of Ophthalmology
Purpose: To determine the relationship between HbA1c and severity of retinopathy in diabetic patients. Study Design: Cross sectional study. Place and Duration of Study: Eye department of DHQ-UTH Gujranwala, from July 2020 to Dec 2020. Methods: An observational cross-sectional study including 100 patients was conducted at eye department of DHQ-UTH Gujranwala from January 2018 to December 2018. After approval from institutional review board, written informed consent with demographic variables was collected from every patient. Patients of either gender between 40-80 years of age with both types I and type II diabetes were included in this study. Complete ophthalmic examination including Best Corrected Visual Acuity, slit lamp biomicroscopy, Goldmann Applanation tonometry and fundus examination carried out. Diabetic retinopathy was classified from grade 0 to grade 5. Results: Out of 100 patients, 46 (46%) were males and 54 (54%) were females. Mean age was 60 ± 2.4 years with a rang...
ABSTRACT Objective: Early worsening of diabetic retinopathy (EWDR) due to the rapid decrease of blood glucose levels is a concern in diabetes treatment. The aim of the present study was to evaluate whether this is an important issue in subjects with type 2 diabetes with mild or moderate non-proliferative DR (NPDR), which represent the vast majority of subjects with DR attended in the Primary Care. Research Design and Methods: retrospective nested case-control study of subjects with type 2 diabetes and previous mild or moderate NPDR. Using SIDIAP (“Sistema d'informació pel Desenvolupament de la Recerca a Atenció Primària”) database, we selected 1,150 individuals with EWDR and 1,150 matched controls (DR without EWDR). The main variable analyzed was the magnitude of the reduction of HbA1c in previous 12 months. The reduction of HbA1c was categorized in rapid (>1.5% reduction in < 12 months) and very rapid (>2% in <6 months). Results: We did not find any significan...
KYAMC Journal
Background: Retinopathy is the leading cause of blindness in persons with diabetes. Strict monitoring and maintenance of normal blood glucose specially HbA1c and prevention of different risk factors can prevent and delay the diabetic retinopathy. The purpose of the study was to explore the factors influencing or related to the development of the diabetic retinopathy with spcial concern to the HbA1c levels. Materials and Methods: We studied 400 type 2 diabetic patients in this cross-sectional study which was conducted in the outpatient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of retinopathy through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, BMI) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's t-test, Chi-square test and logistic regression analysis to determine and quantify the association of diabetic retinopathy with various risk factors specially HbA1c. Results: 400 type 2 diabetic patients (male 166 and female 234) were studied. The prevalence of retinopathy was 12.3%; male 12.7%, female 12.0%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of retinopathy (4.2 vs 12.3 vs 18.1%; 2 = 12.529, p < .01). Logistic regression models of univariate analysis showed that the risk of retinopathy at HbA1c categories >7.0% was (
Cureus
Introduction: Diabetes mellitus (DM) is considered to be a significant public health problem globally. According to the American Society of Retina Specialists, diabetic retinopathy (DR) is a complication of diabetes that causes damage to the blood vessels of the retina. In a Japanese study showed that HbA1c and fasting blood glucose values can be considered as predictors for the future development of DR. Thus, this study aimed to determine the prevalence and severity of DR among diabetic patients in Medina, Saudi Arabia, and to assess its relationship with HbA1c and other biomarkers.
Biological Variation in HbA1c Predicts Risk of Retinopathy and Nephropathy in Type 1 Diabetes
Diabetes Care, 2004
OBJECTIVE-We hypothesized that biological variation in HbA 1c , distinct from variation attributable to mean blood glucose (MBG), would predict risk for microvascular complications in the Diabetes Control and Complications Trial (DCCT). RESEARCH DESIGN AND METHODS-A longitudinal multiple regression model was developed from MBG and HbA 1c measured in the 1,441 DCCT participants at quarterly visits. A hemoglobin glycation index (HGI ϭ observed HbA 1c-predicted HbA 1c) was calculated for each visit to assess biological variation based on the directional deviation of observed HbA 1c from that predicted by MBG in the model. The population was subdivided by thirds into high-, moderate-, and low-HGI groups based on mean participant HGI during the study. Cox proportional hazard analysis compared risk for development or progression of retinopathy and nephropathy between HGI groups controlled for MBG, age, treatment group, strata, and duration of diabetes. RESULTS-Likelihood ratio and t tests on HGI rejected the assumption that HbA 1c levels were determined by MBG alone. At 7 years' follow-up, patients in the high-HGI group (higherthan-predicted HbA 1c) had three times greater risk of retinopathy (30 vs. 9%, P Ͻ 0.001) and six times greater risk of nephropathy (6 vs. 1%, P Ͻ 0.001) compared with the low-HGI group. CONCLUSIONS-Between-individual biological variation in HbA 1c , which is distinct from that attributable to MBG, was evident among type 1 diabetic patients in the DCCT and was a strong predictor of risk for diabetes complications. Identification of the processes responsible for biological variation in HbA 1c could lead to novel therapies to augment treatments directed at lowering blood glucose levels and preventing diabetes complications.
Association of HbA1c levels with diabetic retinopathy
Indian Journal of Clinical and Experimental Ophthalmology
To study the association of HbA1C levels with diabetic retinopathy. A total of 330 diagnosed diabetic subjects of all age groups and genders participated in the study. They were grouped according to presence or absence of diabetic retinopathy. All patients HbA1C levels along with fasting blood glucose levels was obtained. Observations were made to find the association between HbA1C levels and diabetic retinopathy. Mean HbA1c level among diabetic retinopathy subjects (9.50) was higher than subjects without retinopathy (8.49). The difference was found to be statistically significant (p < 0.05). With high HbA1c levels high mean fasting blood glucose levels were associated (R value: 0.5856). This is a moderate positive correlation. As glycosylated haemoglobin (HbA1c) levels increases prevalence of diabetic retinopathy also increases and there is a strong relationship between HbA1c levels and diabetic retinopathy.
Correlation of blood sugar and HbA1C levels in different stage of diabetes retinopathy
International journal of health sciences
Objectives: This present study was to evaluate the different parameters and correlation of blood sugar and HbA1C levels for the development of retinopathy in type 2 diabetes mellitus patients. Methods: A complete assessment, general physical examination and routine haematological investigations were performed to all patients. A complete fundus examination was done with the help of direct and indirect Ophthalmoscope. Biochemical investigations (Blood Sugar- Fasting and Post Prandial, HbA1C level) were performed. Patients were called for follow up after 1 month, 3 months and 6 months. Results: A total of 100 patients of diabetes retinopathy were enrolled in this study. Most of the cases 67(67%) were males with age group of 51-60 years. out of 191 eyes, most of the cases 72(37.7%) had PDR. Rest cases had 58(30.36%) severe NPDR, 46(24.08%) moderate NPDR, 9(4.71%) others and 6(3.14%) mild NPDR. HbA1c levels of the most of the cases 94(49.21%) had 6.5-8.5. Most of the patients 170(89.53%...