In the early stages of diabetic retinopathy, little can be done beyond watchful waiting and managing blood sugar levels (glycemic control). Standard approaches to glycemic control aim for a blood sugar level of 7.0 to 7.9 percent.
Several years ago, a major study known as ACCORD explored multiple approaches to reducing cardiovascular risk associated with type 2 diabetes. One approach was intensive glycemic control with a target of less than 6 percent.
That part of the study ended early due to an unexplained increase in the number of deaths. But the data showed that the intensive control participants had a significant reduction in their risk of retinopathy progression, which continued even after glycemic levels returned to the level achieved with standard management.
A follow-up study now shows that the benefit is long-term. Researchers followed more than 1,300 participants for an additional four years and found that the reduced risk of retinopathy progression had continued.
It isn’t clear why the risk reduction continued after intensive management ended. But other studies have had similar results.
It also isn’t known whether the increased number of deaths in the earlier study was related to intensive management. But if you have diabetes, discuss both the risks and potential benefits of different options for glycemic control with your physicians, including your eye doctor. They can help you decide which is the best option for you.
Source: Diabetes Care, published online June 11, 2016