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(English) Small Change, Big Rewards in A1c and Blood Pressure Control for Diabetes Patients
Small Change, Big Rewards in A1c and Blood Pressure Control for Diabetes Patients
Controlling hemoglobin A1c levels and reducing blood pressure have a significant impact on modifying diabetic retinopathy (DR) progression, stated Dr. Allen S. Ho, MD, at Retina 2015. Diabetic retinopathy is a leading cause of blindness among working adults worldwide, and diabetic macular edema (DME), is a complication of diabetic retinopathy.
The average A1c level among patients with diabetic retinopathy is 9, and each 1% increase in A1c level above 7 increases the chance of the incidence of progression to proliferative diabetic retinopathy by 50% and increases the chance of development of diabetic macular edema by 40%, stated Dr. Ho. «Conversely, if you reduce your A1c by 1% when it’s elevated, you reduce your chance of diabetic macular edema by 40% for each elevated increment of 1%.»
This relationship holds true whether the patient has type 1 or type 2 diabetes, whether macular edema is proliferative or non-proliferative, or whether disease is mild, moderate or severe.
Blood pressure control and lipid management, too, can impact diabetic retinopathy progression. The American Diabetes Association recommends a target blood pressure of 130/80 mm Hg or less, and each 10 mm Hg reduction in systolic pressure when blood pressure is elevated reduces microvascular complications of diabetic retinopathy by 10%, regardless of severity of hypertension.
«We can modify progression of diabetic retinopathy by getting back to basics with glycemic control, blood pressure control and lipid management,» commented Dr. Ho.