Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0180252
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dc.titleCombined poor diabetes control indicators are associated with higher risks of diabetic retinopathy and macular edema than poor glycemic control alone
dc.contributor.authorFenwick E.K.
dc.contributor.authorXie J.
dc.contributor.authorMan R.E.K.
dc.contributor.authorSabanayagam C.
dc.contributor.authorLim L.
dc.contributor.authorRees G.
dc.contributor.authorWong T.Y.
dc.contributor.authorLamoureux E.L.
dc.date.accessioned2020-03-19T09:02:36Z
dc.date.available2020-03-19T09:02:36Z
dc.date.issued2017
dc.identifier.citationFenwick 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
dc.identifier.issn1932-6203
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/165791
dc.description.abstractPurpose: 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.
dc.publisherPublic Library of Science
dc.sourceUnpaywall 20200320
dc.subjecthemoglobin A1c
dc.subjecthigh density lipoprotein
dc.subjectlow density lipoprotein
dc.subjecttriacylglycerol
dc.subjectadult
dc.subjectArticle
dc.subjectblood pressure regulation
dc.subjectblood sampling
dc.subjectcholesterol blood level
dc.subjectcontrolled study
dc.subjectcross-sectional study
dc.subjectdiabetes control
dc.subjectdiabetic macular edema
dc.subjectdiabetic retinopathy
dc.subjectdisease association
dc.subjectfemale
dc.subjectglycemic control
dc.subjecthigh risk population
dc.subjecthuman
dc.subjectinsulin dependent diabetes mellitus
dc.subjectlipid analysis
dc.subjectlipid blood level
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectnon insulin dependent diabetes mellitus
dc.subjectophthalmoscopy
dc.subjectoptical coherence tomography
dc.subjectrisk assessment
dc.subjectrisk factor
dc.subjecttriacylglycerol blood level
dc.subjectaged
dc.subjectblood
dc.subjectcomplication
dc.subjectdiabetic retinopathy
dc.subjectmacular edema
dc.subjectmiddle aged
dc.subjectnon insulin dependent diabetes mellitus
dc.subjectAged
dc.subjectCross-Sectional Studies
dc.subjectDiabetes Mellitus, Type 2
dc.subjectDiabetic Retinopathy
dc.subjectFemale
dc.subjectHumans
dc.subjectMacular Edema
dc.subjectMale
dc.subjectMiddle Aged
dc.typeArticle
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.doi10.1371/journal.pone.0180252
dc.description.sourcetitlePLoS ONE
dc.description.volume12
dc.description.issue6
dc.description.pagee0180252
dc.published.statePublished
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