Glucose serves as a vital energy source for our bodies, but it needs to be maintained within normal levels to prevent serious complications. One such complication is retinopathy, resulting from damage to the eye’s retina capillaries.
Controlling blood glucose levels is crucial in preventing retinopathy development. Elevated glucose levels can damage the endothelial cells of capillaries, nourishing the retina and negatively impacting vision. Stable glucose levels help preserve vision and prevent retina capillary damage.
Research indicates that low HbA1c levels, reflecting average blood sugar levels over time, are associated with a reduced risk of diabetes microvascular complications, including retinopathy. This finding underscores the importance of glucose monitoring and understanding protein glycation in diabetes complications formation [1].
Studies such as the Diabetes Control and Complications Trial (DCCT) and the UK Prospective Diabetes Study (UKPDS) have shown statistically significant reductions in retinopathy cases among patients receiving intensive glucose control.
The DCCT, conducted on over 1400 patients with type 1 diabetes, demonstrated a 76% reduction in retinopathy risk with intensive glucose control compared to standard control, evident after approximately 2.5 years of observation.
The UKPDS, involving over 5000 patients with type 2 diabetes, revealed a 25% reduced risk of retinopathy development with intensive glucose control compared to a standard control, a statistically significant effect observed after at least 10 years of observation.
Additionally, research has shown that increased glucose levels can temporarily exacerbate retinopathy, known as “early worsening.” It occurs due to a decrease in oxygen balance in the retina, which in turn can lead to the appearance of new damage. Secondly, it has been found that patients under intensive glucose level control experience noticeably slower progression of retinopathy over 10 years after the cessation of treatment. This phenomenon, known as “metabolic memory,” indicates that chronic hyperglycemia can induce long-lasting changes in the body, which may be partially reversible [1].
Additionally, research indicates a link between hypertension and retinopathy development in diabetic individuals. High systolic blood pressure values were associated with retinopathy in type 2 diabetes patients. Blood pressure control showed retinopathy progression reduction, irrespective of glycemic levels. Controlled blood pressure also proved beneficial in reducing macro- and microvascular complications associated with type 2 diabetes, highlighting its importance in managing this condition [2].
The significance of glucose and blood pressure control extends beyond retinopathy prevention, which is crucial in preventing cardiovascular diseases in diabetic patients. Intensive glucose control, for instance, can reduce the risk of heart attack, stroke, and cardiovascular-related death [3].
It’s important to remember that both very high and deficient glucose levels can be dangerous, and sharp fluctuations between them can lead to harmful consequences. Regular glucose monitoring, healthy eating, and an active lifestyle are essential for maintaining eye and overall organ health.
Sources:
- Frank, R. N. (2015). Diabetic retinopathy and systemic factors. Middle East African journal of ophthalmology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411610/.
- Klein, R., & Klein, B. E. K. (2002, April). Blood pressure control and diabetic retinopathy. The British journal of ophthalmology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1771074/.
- VA research on Diabetes. U.S. Department of Veterans Affairs. (n.d.). https://www.research.va.gov/topics/diabetes.cfm.