HINES, IL — Intensive glycemic control (INT) does not appear to have a protective effect when it comes to required eye procedures in patients with advanced diabetes.
That’s according to a VA study that sought to determine the long-term role of INT compared with standard glycemic control in eye procedures over the years in those patients.
Researchers from the Edward Hines Jr. VA Hospital compared the effect of treatment assignment on the accumulated number of eye procedures during the intervention period of the Veteran Affairs Diabetes Trial (VADT) from 2000-2008, with median follow-up of 5.6 years. They also reviewed the interim VADT follow-up study from 2000-2013, as well as the full 17 years of VADT follow-up to 2017.
Also analyzed were data using a range of various cardiovascular markers in two models—Model 1 included total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, systolic and diastolic blood pressure, while BMI. Model II included these measurements plus age and diabetic retinopathy (DR) severity score at baseline of the original trial.
The report in Diabetes Care advises that data indicated a slight but nonsignificant increase in the number of procedures and in retinal or retinal plus cataract surgery during the three periods of the study.1
“We found no significant benefit of INT during the original trial period in eye-related procedures, such as various procedures for DR, or during the 17 years of follow-up in cataract surgery,” the authors write. “However, after adjusting data for some known vascular markers, the increase in the number of eye procedures with INT becomes more prevalent. This finding indicates that INT might not have a protective role in events requiring surgery in individuals with advanced diabetes.”
- Azad N, Agrawal L, Bahn G, Emanuele NV, Reaven PD, Hayward R, Reda D; VADT Study Group. Eye Outcomes in Veteran Affairs Diabetes Trial (VADT) After 17 Years. Diabetes Care. 2021 Jun 29:dc202882. doi: 10.2337/dc20-2882. Epub ahead of print. PMID: 34187839.