Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0180252
Title: Combined poor diabetes control indicators are associated with higher risks of diabetic retinopathy and macular edema than poor glycemic control alone
Authors: Fenwick E.K.
Xie J.
Man R.E.K.
Sabanayagam C. 
Lim L.
Rees G.
Wong T.Y. 
Lamoureux E.L. 
Keywords: hemoglobin A1c
high density lipoprotein
low density lipoprotein
triacylglycerol
adult
Article
blood pressure regulation
blood sampling
cholesterol blood level
controlled study
cross-sectional study
diabetes control
diabetic macular edema
diabetic retinopathy
disease association
female
glycemic control
high risk population
human
insulin dependent diabetes mellitus
lipid analysis
lipid blood level
major clinical study
male
non insulin dependent diabetes mellitus
ophthalmoscopy
optical coherence tomography
risk assessment
risk factor
triacylglycerol blood level
aged
blood
complication
diabetic retinopathy
macular edema
middle aged
non insulin dependent diabetes mellitus
Aged
Cross-Sectional Studies
Diabetes Mellitus, Type 2
Diabetic Retinopathy
Female
Humans
Macular Edema
Male
Middle Aged
Issue Date: 2017
Publisher: Public Library of Science
Citation: Fenwick E.K., Xie J., Man R.E.K., Sabanayagam C., Lim L., Rees G., Wong T.Y., Lamoureux E.L. (2017). Combined poor diabetes control indicators are associated with higher risks of diabetic retinopathy and macular edema than poor glycemic control alone. PLoS ONE 12 (6) : e0180252. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0180252
Abstract: Purpose: To examine the association of individual and combined indicators of diabetes control with diabetic retinopathy and diabetic macular edema. Materials and methods: In this clinical, cross-sectional study, 613 adults with type 2 diabetes (372 any diabetic retinopathy; 183 any diabetic macular edema) were examined. Diabetic retinopathy was assessed from fundus photographs; diabetic macular edema from Ocular Coherence Tomography scans; and HbA1c and serum lipid values from fasting blood samples. Poor glucose control was defined as HbA1c?7%; poor blood pressure control as SBP?130/DBP?80; and poor lipid control as total cholesterol:HDL ratio?4.0. The association of poor glucose control, poor blood pressure control and poor lipid control alone and in combination (poor glucose & blood pressure control; poor glucose & lipid control; poor blood pressure & lipid control; and poor glucose, blood pressure & lipid control) with diabetic retinopathy/diabetic macular edema was examined using multiple logistic regression models. Results: Patients' mean±standard deviation age was 64.9±11.6 years (57% male). In adjusted models, compared to those with good control of all indicators (n = 99, 18.3%), the odds ratio (95% Confidence Interval) of having any diabetic retinopathy was 2.44 (1.34-4.46), 3.75 (1.75-8.07), 4.64 (2.13-10.12) and 2.28 (1.01-5.16) for poor glucose control only; poor glucose & blood pressure control; poor glucose & lipid control; and poor glucose, blood pressure & lipid control, respectively. Correspondingly for diabetic macular edema, they were 3.19 (1.55-6.59); 3.60 (1.58-8.22); 2.76 (1.18-6.44); and 3.01 (1.18-7.67), respectively. Odds were not significantly increased for other indicators. Discussion: Compared to individual indicators of poor diabetes control, risk of diabetic retinopathy and diabetic macular edema increased three to fourfold with a combination of these indicators. Targeting combined diabetes control indicators is important to reduce risk of diabetic retinopathy/diabetic macular edema. © 2017 Fenwick et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/165791
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0180252
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