{"title":"强化血糖控制对2型糖尿病视网膜病变改变的影响：一项前瞻性观察队列研究。","authors":"Xinyan Wu, Yayi Yan, Yuntong Li, Yiran Fan, Lingyi Li, Ching-Kit Tsui, Kaiqun Liu, Xiaoling Liang, Wenyong Huang, Andina Hu","doi":"10.1186/s12886-025-04139-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A large body of evidence supports the long-term benefits of intensive glycemic control for patients with type 2 diabetes mellitus (T2DM). However, the relationship between intensive glycemic control and diabetic retinopathy (DR) progression in T2DM patients in the short-term remains under debate. Therefore, we investigated the effect of intensive glycemic control on DR changes in the short-term.</p><p><strong>Methods: </strong>A total of 254 patients with T2DM, all exhibition hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels above 7% were included in the study. We collected HbA<sub>1c</sub> values at baseline and after 12-months. HbA<sub>1c</sub> control classified into two categories: intensive control, targeting an HbA<sub>1c</sub> of less than 7%, and less intensive control, targeting an HbA<sub>1c</sub> of 7% or higher at 12-month follow-up. The severity of DR were graded based on seven-field 45° conventional fundus photographs examinations according to the United Kingdom National Diabetic Eye Screening Program guidelines.</p><p><strong>Results: </strong>After a one-year follow-up, 129 participants achieved a target HbA<sub>1c</sub> of less than 7% and 125 achieved 7% or more. We found no significant difference in DR changes (incidence, progression, or regression) between two groups after adjustments for age and gender. Further adjustments for confounding factors such as body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), diabetes duration, insulin use and baseline HbA<sub>1c</sub>, revealed no association between intensive glycemic control and the DR changes.</p><p><strong>Conclusions: </strong>This prospective cohort study demonstrates that intensive glycemic control did not associated with DR changes in T2DM patients in the short term. Further research is required to ascertain the long-term effects of intensive glycemic control on DR.</p><p><strong>Trial registration: </strong>The trail has been registered at The UK's Clinical Study Registry ( https://www.isrctn.com ) on 2020/04/13 (ISRCTN15853192).</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"313"},"PeriodicalIF":1.7000,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105227/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of intensive glycemic control on the changes of diabetic retinopathy in type 2 diabetes: a prospective observational cohort study.\",\"authors\":\"Xinyan Wu, Yayi Yan, Yuntong Li, Yiran Fan, Lingyi Li, Ching-Kit Tsui, Kaiqun Liu, Xiaoling Liang, Wenyong Huang, Andina Hu\",\"doi\":\"10.1186/s12886-025-04139-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A large body of evidence supports the long-term benefits of intensive glycemic control for patients with type 2 diabetes mellitus (T2DM). However, the relationship between intensive glycemic control and diabetic retinopathy (DR) progression in T2DM patients in the short-term remains under debate. Therefore, we investigated the effect of intensive glycemic control on DR changes in the short-term.</p><p><strong>Methods: </strong>A total of 254 patients with T2DM, all exhibition hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels above 7% were included in the study. We collected HbA<sub>1c</sub> values at baseline and after 12-months. HbA<sub>1c</sub> control classified into two categories: intensive control, targeting an HbA<sub>1c</sub> of less than 7%, and less intensive control, targeting an HbA<sub>1c</sub> of 7% or higher at 12-month follow-up. The severity of DR were graded based on seven-field 45° conventional fundus photographs examinations according to the United Kingdom National Diabetic Eye Screening Program guidelines.</p><p><strong>Results: </strong>After a one-year follow-up, 129 participants achieved a target HbA<sub>1c</sub> of less than 7% and 125 achieved 7% or more. We found no significant difference in DR changes (incidence, progression, or regression) between two groups after adjustments for age and gender. Further adjustments for confounding factors such as body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), diabetes duration, insulin use and baseline HbA<sub>1c</sub>, revealed no association between intensive glycemic control and the DR changes.</p><p><strong>Conclusions: </strong>This prospective cohort study demonstrates that intensive glycemic control did not associated with DR changes in T2DM patients in the short term. Further research is required to ascertain the long-term effects of intensive glycemic control on DR.</p><p><strong>Trial registration: </strong>The trail has been registered at The UK's Clinical Study Registry ( https://www.isrctn.com ) on 2020/04/13 (ISRCTN15853192).</p>\",\"PeriodicalId\":9058,\"journal\":{\"name\":\"BMC Ophthalmology\",\"volume\":\"25 1\",\"pages\":\"313\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-05-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105227/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12886-025-04139-z\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12886-025-04139-z","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Effect of intensive glycemic control on the changes of diabetic retinopathy in type 2 diabetes: a prospective observational cohort study.
Background: A large body of evidence supports the long-term benefits of intensive glycemic control for patients with type 2 diabetes mellitus (T2DM). However, the relationship between intensive glycemic control and diabetic retinopathy (DR) progression in T2DM patients in the short-term remains under debate. Therefore, we investigated the effect of intensive glycemic control on DR changes in the short-term.
Methods: A total of 254 patients with T2DM, all exhibition hemoglobin A1c (HbA1c) levels above 7% were included in the study. We collected HbA1c values at baseline and after 12-months. HbA1c control classified into two categories: intensive control, targeting an HbA1c of less than 7%, and less intensive control, targeting an HbA1c of 7% or higher at 12-month follow-up. The severity of DR were graded based on seven-field 45° conventional fundus photographs examinations according to the United Kingdom National Diabetic Eye Screening Program guidelines.
Results: After a one-year follow-up, 129 participants achieved a target HbA1c of less than 7% and 125 achieved 7% or more. We found no significant difference in DR changes (incidence, progression, or regression) between two groups after adjustments for age and gender. Further adjustments for confounding factors such as body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), diabetes duration, insulin use and baseline HbA1c, revealed no association between intensive glycemic control and the DR changes.
Conclusions: This prospective cohort study demonstrates that intensive glycemic control did not associated with DR changes in T2DM patients in the short term. Further research is required to ascertain the long-term effects of intensive glycemic control on DR.
Trial registration: The trail has been registered at The UK's Clinical Study Registry ( https://www.isrctn.com ) on 2020/04/13 (ISRCTN15853192).
期刊介绍：
BMC Ophthalmology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of eye disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
