Year: 2010
Type: article
Abstract: OBJECTIVE: To re-evaluate the relationship between glycemia and diabetic retinopathy. RESEARCH DESIGN AND METHODS: We conducted a data-pooling analysis of nine studies from five countries with 44,623 participants aged 20-79 years with gradable retinal photographs. The relationship between diabetes-specific retinopathy (defined as moderate or more severe retinopathy) and three glycemic measures (fasting plasma glucose [FPG; n = 41,411], 2-h post oral glucose load plasma glucose [2-h PG; n = 21,334], and A1C [n = 28,010]) was examined. RESULTS: When diabetes-specific retinopathy was plotted against continuous glycemic measures, a curvilinear relationship was observed for FPG and A1C. Diabetes-specific retinopathy prevalence was low for FPG <6.0 mmol/l and A1C <6.0% but increased above these levels. Based on vigintile (20 groups with equal numbers) distributions, glycemic thresholds for diabetes-specific retinopathy were observed over the range of 6.4-6.8 mmol/l for FPG, 9.8-10.6 mmol/l for 2-h PG, and 6.3-6.7% for A1C. Thresholds for diabetes-specific retinopathy from receiver-operating characteristic curve analyses were 6.6 mmol/l for FPG, 13.0 mmol/l for 2-h PG, and 6.4% for A1C. CONCLUSIONS: This study broadens the evidence based on diabetes diagnostic criteria. A narrow threshold range for diabetes-specific retinopathy was identified for FPG and A1C but not for 2-h PG. The combined analyses suggest that the current diabetes diagnostic level for FPG could be lowered to 6.5 mmol/l and that an A1C of 6.5% is a suitable alternative diagnostic criterion.
Source: Diabetes Care
DOI: 10.2337/dc10-1206
Institutions: The University of Sydney, The University of Melbourne, National University of Singapore, Centre for Eye Research Australia, Singapore Eye Research Institute, Université Paris-Sud, Inserm, Centre de recherche en Epidémiologie et Santé des Populations, Baker Heart and Diabetes Institute, Aarhus University
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: G118440752, G1325221871, G136105103, Atherosclerosis Risk in Communities Study (ARIC), G215333750, CCSP FIELD CENTER, G25881238, COMMUNITY AND COHORT SURVEILLANCE PROGRAM, CENTRAL HEMOSTATIS LABORATORY FOR CCSP, G3236609591, G390162502, Atherosclerosis Risk in Communities Study (ARIC), G528395701, G5451084504, Atherosclerosis Risk in Communities Study (ARIC), G6203107232, G786153652, G793702358, G812579647, G8486527673, Atherosclerosis Risk in Communities Study (ARIC)
OpenAlex ID: W2134739555