Rapid control of HbA1c is not linked with progression from nonproliferative diabetic retinopathy (NPDR) to vision-threatening diabetic retinopathy (VTDR) or proliferative diabetic retinopathy (PDR) to diabetic macular edema (DME), according to research results presented at the American Academy of Ophthalmology 2021 Annual Meeting.

Early paradoxical worsening of diabetic retinopathy can follow quick improvement in blood glucose. Researchers analyzed the risk of progression in diabetic retinopathy.

They reviewed national insurance claims database medical records of 20,984 patients with NPDR and compared decreases in HbA1c spanning 6 months.

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Utilizing multivariable Cox proportional hazard regression modeling, the researchers determined what change in HbA1c was required for progression to VTDR, PDR, and DME.

They found that 14,248 patients had more than a 2% drop in A1c, 13,567 patients had more than a 3% drop, and 12,844 patients had more than a 4% drop.

They did not find a higher risk of progression to VTDR in any cohort (OR 1.00-1.02 P >.74), PDR (OR 0.93-0.98 P >.49), or DME (OR 1.01-1.02 P >.69).


Tauqueer Z, Bracha P, Hua P, et al. Rapid improvement in blood glucose and risk of progression from NPDR to vision-threatening diabetic retinopathy. Presented at: The American Academy of Ophthalmology 2021 Annual Meeting; November 12-15; New Orleans. Abstract PO368.

This article originally appeared on Ophthalmology Advisor