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Uncontrolled blood glucose, kidney disease, and foot ulcers are linked to an increased risk of developing diabetes-related vision loss.

Predicting Development of Proliferative Diabetic Retinopathy. By Kristen Harris Nwanyanwu and colleagues. Diabetes Care 2013, pages 1562–1568


What is the problem and what is known about it so far?

People with diabetes are at an increased risk of eye disease (retinopathy), which is the most common cause of new cases of blindness in the United States. The greatest risk is in people who progress from nonproliferative retinopathy, which is caused by leaky blood vessels, to proliferative retinopathy, which occurs when eye blood vessels start to grow unchecked, threatening vision.

Why did the researchers do this particular study?

The researchers wanted to be able to identify people at the highest risk for progressing from nonproliferative to proliferative retinopathy.

Who was studied?

The study included 4,617 people who had nonproliferative retinopathy at the start of the study.

How was the study done?

Researchers monitored the health of participants and checked for the development of proliferative retinopathy between 2001 and 2009.

What did the researchers find?

Every 1-point increase in A1C, the average blood glucose over the previous 2–3 months, was associated with a 14 percent greater risk for developing proliferative retinopathy. Participants with foot ulcers, wounds that are hard to heal, or kidney disease were also at a greater risk for developing proliferative retinopathy.

What were the limitations of the study?

This type of study cannot prove that any of the risk factors caused progression from nonproliferative to proliferative retinopathy. Also, the researchers did not take into account the severity of participants’ nonproliferative retinopathy at the start of the study.

What are the implications of the study?

The risk factors identified in this study may help eye doctors assess patients and make clinical decisions, such as how often patients should have their eyes checked.

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