Glycemic thresholds for diabetes-specific retinopathy: Implications for diagnostic criteria for diabetes
MetadataShow full item record
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.
Showing items related by title, author, creator and subject.
Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network projectBrazionis, L.; Jenkins, A.; Keech, A.; Ryan, C.; Brown, A.; Boffa, John; Bursell, S. (2018)Aim: To determine diabetic retinopathy prevalence and severity among remote Indigenous Australians. Methods: A cross-sectional diabetic retinopathy screening study of Indigenous adults with Type 2 diabetes was conducted ...
Clifford, Rhonda (2004)People with diabetes mellitus are more likely to die from cardiovascular causes than those without diabetes, and modifiable risk factors, such as hyperglycaemia, dyslipidaemia and hypertension can be targeted in intervention ...
Jiwa, Moyez; Freeman, J.; Clayton, C.; Bundy, J.; Wilson, P. (2004)The natural history of impaired carbohydrate metabolism has not been established although the importance of identifying patients with abnormally high blood glucose levels has been highlighted internationally. This survey ...