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How to perform better intervention to prevent and control diabetic retinopathy among patients with type 2 diabetes: A

Mayinuer Yusufu1, Xuxi Zhang2, Xinying Sun3

  • 1Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Diabetes Research and Clinical Practice
|September 25, 2019
PubMed

Insights

Targeting modifiable risk factors effectively prevents and controls diabetic retinopathy (DR) in type 2 diabetes patients. Multifactorial interventions and longer follow-up periods show the best results for DR prevention and management.

Area of Science:

  • Ophthalmology
  • Endocrinology
  • Preventive Medicine

Background:

  • Diabetic retinopathy (DR) is a leading cause of blindness in type 2 diabetes patients.
  • Modifiable risk factors significantly influence DR development and progression.
  • Effective interventions are crucial for managing DR and preventing vision loss.

Purpose of the Study:

  • To evaluate the efficacy of interventions targeting modifiable risk factors for DR prevention and control in type 2 diabetes.
  • To compare different intervention types and follow-up intervals for optimal DR management.
  • To provide evidence-based recommendations for clinical practice.

Main Methods:

  • Meta-analysis of 22 randomized controlled trials (RCTs) involving 22,511 patients.
  • Literature search conducted on PubMed, Embase, and ScienceDirect before June 1, 2019.
  • Random effects models used to calculate pooled Odds Ratios (OR) for DR development and worsening.

Main Results:

  • Interventions targeting modifiable risk factors significantly reduced the risk of developing DR (OR=0.60) and DR worsening (OR=0.62).
  • Multifactorial interventions demonstrated superior efficacy compared to single-factor interventions for both DR development and progression.
  • Blood-pressure-control interventions were specifically effective in slowing DR worsening.
  • Longer follow-up intervals (>5 years for development, >2 years for worsening) were associated with better outcomes.

Conclusions:

  • Interventions targeting modifiable risk factors are effective in preventing and controlling diabetic retinopathy in type 2 diabetes.
  • Multifactorial interventions and longer follow-up periods are recommended for optimal DR management.
  • Blood pressure control plays a critical role in slowing DR progression.
Keywords:
Diabetic retinopathyMeta-analysisMultifactorial interventionPreventionType 2 diabetes

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