Association between HbA 1C variability and the incidence of diabetes retinopathy in patients with type 2 diabetes / 中华内分泌代谢杂志

ABSTRACT

Objective:To analyze the association between HbA 1C variability and the incidence of diabetes retinopathy in patients with type 2 diabetes mellitus(T2DM). Methods:All the patients with type 2 diabetes receiving regular follow-up were enrolled from Lee′s Joint Clinic from 2002 to 2014. Demographic and laboratory data like HbA 1C were collected including fundal examination. According to HbA 1C variability, which was defined as the difference between baseline and last available HbA 1C, participants were divided into three groups, stable group with HbA 1C variability of ±10%, increase group(>10%), and decline group(<-10%). Results:A total of 3 657 T2DM participants were recruited including 662(13.4%) participants with diabetes retinopathy. Blood glucose gradually rose from ideal level [HbA 1C(7.04±1.35)%] and HbA 1C was up to (9.11±1.96)% at the end of follow-up in increase group. HbA 1C gradually fell to (7.27±1.12)% from (10.05±1.99)% of baseline in decline group. HbA 1C of the third group remained relatively stable. Adjusted for age, body mass index, systolic blood pressure, pulse pressure, duration of diabetes, mean HbA 1C of follow-up, glaucoma and so on, logistic regression revealed that participants in stable group( OR=0.800, 95% CI 0.645-0.992) and increase group( OR=0.706, 95% CI 0.548-0.909) had a lower risk of diabetes retinopathy than decline group( P<0.05). Conclusion:HbA 1C variability is an important risk factor of diabetes retinopathy in patients with T2DM. Patients with blood glucose declined had increased risk of diabetes retinopathy as compared to those with rising HbA 1C.