EFFECTS OF GLYCEMIC VARIABILITY ON THE PROGRESSION OF DIABETIC RETINOPATHY AMONG PATIENTS WITH TYPE 2 DIABETES

Purpose: To evaluate the effects of glycemic variability on the progression of diabetic retinopathy (DR) among individuals with Type 2 diabetes and to test the hypothesis that consistent glycemic control delays the progression of DR. Methods: This retrospective study included 1,125 participants with a follow-up period of more than 5 years and more than 20 glucose laboratory test results. The hazard ratio of >= 3 steps of progression on the Early Treatment Diabetic Retinopathy Study person scale and progression to proliferative DR were assessed. Results: An increase in the HbA1c SD was associated with a higher risk of >= 3 step progression (P < 0.001) and progression to proliferative DR (P < 0.001). Not only mean HbA1c, but also HbA1c SD was associated with a lower risk of >= 3 steps of progression (P < 0.001), and progression to proliferative DR (P < 0.001). Conclusion: Achievable and consistent glycemic control may contribute to the delay in DR progression.