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Control glucémico a largo plazo y retinopatía diabética
D R McCance1, D R Hadden, A B Atkinson
1Sir George E. Clark Metabolic Unit, Department of Ophthalmology, Queen's University, Belfast.
Lancet (London, England)
|October 7, 1989
Resumen
El control a largo plazo del azúcar en la sangre, medido por hemoglobina glicosilada (HbA1), se correlaciona fuertemente con la gravedad de la retinopatía diabética. Lograr niveles de HbA1 casi normales es crucial para prevenir las complicaciones de la visión en pacientes con diabetes.
Área de la Ciencia:
- Endocrinología Endocrinología.
- Oftalmología Oftalmología.
- Diabetología Diabetología.
Sus antecedentes:
- La retinopatía diabética es una de las principales causas de pérdida de visión en pacientes con diabetes mellitus.
- La relación entre el control glucémico a largo plazo y el desarrollo / progresión de la retinopatía diabética requiere una mayor aclaración.
Objetivo del estudio:
- Investigar la correlación entre los niveles medios de hemoglobina glicosilada en serie (HbA1) y la presencia y gravedad de la retinopatía diabética.
- Para evaluar el umbral de HbA1 asociado con la retinopatía diabética proliferativa.
Principales métodos:
- La fotografía retiniana se realizó en 216 pacientes con diabetes mellitus dependiente de la insulina.
- Los niveles medios de hemoglobina glicosilada (HbA1) se calcularon a partir de mediciones en serie tomadas cada 3 meses durante 6 años.
- Los pacientes fueron categorizados en función de la ausencia o presencia de retinopatía (sin retinopatía, retinopatía de fondo, retinopatía proliferativa).
Principales resultados:
- Se observó una correlación significativa entre los niveles medios más altos de HbA1 y el aumento de la gravedad de la retinopatía diabética.
- La retinopatía proliferativa se encontró exclusivamente en pacientes con niveles medios de HbA1 superiores al 10%.
- Esta asociación persistió incluso después de tener en cuenta la duración de la diabetes.
Conclusiones:
- El control glucémico a largo plazo, reflejado en la HbA1 media, es un factor crítico en el desarrollo de la retinopatía diabética.
- Se recomienda encarecidamente mantener el control glucémico lo más cerca posible de lo normal para mitigar el riesgo y la progresión de la retinopatía diabética.
- Estos hallazgos subrayan la importancia del manejo intensivo de la diabetes para preservar la visión.
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