LARROUMET, A.; RIGO, M.; LECOCQ, M.; DELYFER, Marie-Noelle; KOROBELNIK, Jean-Francois; MONLUN, M.; FOUSSARD, N.; POUPON, P.; BLANCO-BAILLET, Laurence; MOHAMMEDI, Kamel; RIGALLEAU, Vincent

doi:10.1016/j.jdiacomp.2020.107604

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Journal of Diabetes and its Complications. 2020, vol. 34, n° 7, p. 107604

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Aims Does Diabetic Retinopathy (DR) relate to a previous dramatic reduction of HbA1c in Type 2 Diabetes (T2D)? Methods In patients hospitalized for T2D, we collected HbA1c values from previous years, and we defined “Rapid declinors” by a more than −3% reduction between two consecutive HbA1c, and “sustained moderate declinors” by HbA1c declining less than −3%. We analyzed the relation between DR and previous HbA1c courses, adjusted for other risk factors. Results Our 680 patients had a mean HbA1c at 8.7 ± 1.7% at admission and 8.7 ± 1.8 to 9.0 ± 2.2% during previous years (1500 HbA1C values collected), and 24% had a DR. A previous rapid decline of HbA1c occurred in 13.5% of subjects and related to DR (OR = 1.86, 95%CI:1.02–3.40), especially proliferative (OR = 2.64, 95%CI:1.02–6.80), after adjustment for age, gender, body mass index, arterial hypertension and diabetic kidney disease, blood lipids and statin treatment, duration of diabetes and mean previous HbA1c. A previous moderate reduction of HbA1c as occurred in 28.3% other subjects was not related to DR. Conclusions In subjects hospitalized for T2D, a previous rapid decline of HbA1c was related to proliferative DR, whereas a sustained moderate decline appeared to be safe.< Réduire

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Previous dramatic reduction of HbA1c and retinopathy in Type 2 Diabetes

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