Rapid Control of HbA1c Not Associated With Diabetic Retinopathy Progression

Diabetic Retinopathy
Long Standing Diabetic Retinopathy. (Photo By BSIP/UIG Via Getty Images)
Researchers compared decreases in hemoglobin A1c of patients in a national insurance claims database.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the ophthalmology experts at the AAO. Check back for more from the AAO 2021 Meeting.


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.

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).

Visit Ophthalmology Advisor’s conference section for complete coverage of AAO 2021 meeting.



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.