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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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