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Blood Sugar and Cholesterol Control may Retard Diabetic Eye Complications

Another study has shown that in type 2 diabetics, a good control of elevated blood sugar and cholesterol levels retarded the progression of eye changes (diabetic retinopathy). This was an additional substudy finding of the “Action to Control Cardiovascular Risk in Diabetes” (ACCORD), which was published recently in the New England Journal of Medicine.

In the same study, blood pressure control did not appear to have a significant impact on the eye complications. According to the study’s lead author—Emily Chew, MD, from the National Eye Institute, National Institutes of Health, in Bethesda, Maryland—their goal in the study was to find out if intensive blood sugar control, combination therapy for abnormal cholesterol levels, and intensive BP control would limit progression of diabetic retinopathy in patients with type 2 diabetes, since previous data suggested that these risk factors may worsen the development and progression of diabetic retinopathy. The outcomes of the interventions at 4 years were assessed in 2,856 participants.

At the end of the study, the authors concluded: “Intensive glycemic control and intensive combination treatment ofdyslipidemia, but not intensive blood-pressure control, reduced the rate of progression of diabetic retinopathy.”

Although no effect of BP control was noted on eye complications of diabetic retinopathy, Barbara Klein, MD, MPH, from the University of Wisconsin in Madison, pointed out in a separate editorial that this might be because of the duration of follow up in the study. A longer follow-up period might be necessary to show a protective effect of BP-lowering.

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