Is it okay if your blood sugar rises slightly? "Prediabetes" can also lead to vision impairment!

Retinal microangiopathy (DR) is a classic diabetes-related complication that can lead to vision loss
in severe cases.
The study found that DR can also occur in "pre-diabetic" people, and glycosylated hemoglobin (HbA1c) is an important risk factor (a 0.
7% increase in HbA1c increases the risk of DR by 92%)
.
The findings were published in thejournal
Diabetes Care.

During the Diabetes Prevention Program (DPP) and DPP Outcome Study (DPPOS), fundus photography
was performed on adults at high risk of T2D, including those who already had diabetes.
Fundus photographs were graded using the ETDRS grading system, which defined as typical lesions (microaneurysm, exudation, bleeding, or more severe manifestations)
in any eye.

"Slightly elevated blood glucose" should also be a concern, and DR may also occur in prediabetes

By DPPOS year 16, 24% of 1614 T2D subjects and 14% of 885 non-diabetic subjects developed DR.

In univariate analysis, American Indian populations had significantly lower
DR events compared to non-Hispanic whites (NHWs).
Higher blood glucose levels (HbA1c, fasting, OGTT 2-hour blood glucose), greater body weight, history of hypertension, dyslipidemia, and smoking are associated with
more frequent DR events.

Multivariate analysis showed that the US Indian population had significantly fewer DR events compared with NHW (OR 0.
36, 95% CI 0.
20-0.
66), higher mean HbA1c levels were significantly associated with more DR events (OR 1.
92, 95% CI 1.
46-1.
74), and a 92% increase in DR risk for every 0.
7%
increase in HbA1c.

Table 1 Indian population and mean HbA1c level are important risk factors for DR

Summary of this article

After more than ten years of follow-up, it has been found that type 2 diabetes and pre-diabetic people with slightly elevated blood sugar may develop DR, HbA1c is an important risk factor, and the risk of DR increases by 92% for every 0.
7% increase in HbA1c, suggesting clinical attention
.

Compiled by Neil H.
White, Qing Pan, William C.
Knowler, et al.
Diabetes Prevention Program Outcome Study (DPPOS) Research Group:; Risk Factors for the Development of Retinopathy in Prediabetes and Type 2 Diabetes: The Diabetes Prevention Program Experience.
Diabetes Care 1 November 2022; 45 （11）: 2653–2661.
https://doi.
org/10.
2337/dc22-0860