HbA1c, Glycaemic Variability and Diabetic Retinopathy Risk

Pavankumar Kamat


September 17, 2021


  • In patients with diabetes, mean glycated haemoglobin (HbA1c) was associated with an increased risk of developing diabetic retinopathy (DR), but glycaemic variability had no significant association with DR after adjustment for confounders.

Why this matters

  • Findings suggest that HbA1c reduction should be the primary goal in preventing diabetes-related eye disease.

Study design

  • A retrospective observational cohort study included 2511 participants without DR who were followed up for a maximum of 5 years.

  • Primary outcome: development of new-onset DR during the follow-up and the effect of glycaemic variability on the risk of developing DR.

  • Glycaemic variability was evaluated using HbA1c measures.

  • Funding: None.

Key results

  • Of 2511 participants, 542 (21.6%) were diagnosed with DR.

  • Mean HbA1c was significantly associated with a higher risk of developing DR (aOR, 1.038; 95% CI, 1.03-1.05; P<.0001).

  • After adjustment for confounders, glycaemic variability was not significantly associated with a higher risk of developing DR (adjusted OR [aOR], 0.991; 95% CI, 0.97-1.01; P=.3435).

  • Diabetes type was a significant risk factor for the development of DR, with type 1 vs type 2 diabetes associated with an increased risk of developing DR (aOR, 1.632; 95% CI, 1.11-2.40; P=.0125).


  • Retrospective design.

Dhatariya K, Humberstone A, Hasnat A, Wright R, Lujan M, Nunney I. The Association Between Mean Glycated Haemoglobin or Glycaemic Variability and the Development of Retinopathy in People with Diabetes: A Retrospective Observational Cohort Study. Diabetes Ther. 2021 Sep 7 [Epub ahead of print]. doi: 10.1007/s13300-021-01146-3. PMID: 34491530.  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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