Intensive diabetes treatment reduces retinopathy risk

Patients with type 1 diabetes who have been treated with intensive therapy have significantly lower incidences of retinopathy progression up to ten years, according to study results published in the December issue of the Archives of Ophthalmology.

The Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group assessed patients who had been enrolled in the Diabetes Control and Complications Trial (DCCT), which concluded in 1993. Patients in the DCCT were treated with intensive therapy to lower the risk of microvascular diabetic complications when compared with standard therapy. At the four-year follow-up point, patients in the intensive treatment arm had a 70–71% reduced risk of microvascular complications when compared with patients in the conventional treatment study arm.

At year 10 of the EDIC follow-up study, the researchers used fundus photography to assess retinopathy in 1211 subjects. Patients had similar levels of glycated haemoglobin regardless of their initial treatment (standard or intensive), although patients treated intensively had significantly fewer instances of either progression of retinopathy or development of proliferative retinopathy, or worse, after the final DCCT follow-up visit when compared with subjects treated conventionally. The risk reductions experienced by the intensively-treated patients attenuated over the 10-year course of the EDIC trial.

Thus the EDIC Research Group concluded that, though the effects appear to decrease over time, intensive therapy for type 1 diabetes lowers the risk of retinopathy progression.