Glycemic thresholds for diabetes-specific retinopathy: Implications for diagnostic criteria for diabetes
OBJECTIVE :To re-evaluate the relationship between glycemia and diabetic retinopathy. RESEARCH DESIGN AND METHODS: We conducted a data-pooling analysis of nine studies from five countries with 44,623 participants aged 20-79 years with gradable retinal photographs. The relationship between diabetes-s...
| Main Authors: | , , , , , |
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| Format: | Journal Article |
| Published: |
American Diabetes Association
2011
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| Online Access: | http://hdl.handle.net/20.500.11937/5863 |
| _version_ | 1848744914845696000 |
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| author | Colagiuri, S. Lee, Crystal Wong, T. Balkau, B. Shaw, J. Borch-Johnsen, K. |
| author_facet | Colagiuri, S. Lee, Crystal Wong, T. Balkau, B. Shaw, J. Borch-Johnsen, K. |
| author_sort | Colagiuri, S. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | OBJECTIVE :To re-evaluate the relationship between glycemia and diabetic retinopathy. RESEARCH DESIGN AND METHODS: We conducted a data-pooling analysis of nine studies from five countries with 44,623 participants aged 20-79 years with gradable retinal photographs. The relationship between diabetes-specific retinopathy (defined as moderate or more severe retinopathy) and three glycemic measures (fasting plasma glucose [FPG; n = 41,411], 2-h post oral glucose load plasma glucose [2-h PG; n=21,334], and A1C [n=28,010]) was examined. RESULTS: When diabetes-specific retinopathy was plotted against continuous glycemic measures, a curvilinear relationship was observed for FPG and A1C. Diabetes-specific retinopathy prevalence was low for FPG <6.0 mmol/l and A1C <6.0% but increased above these levels. Based on vigintile (20 groups with equal numbers) distributions, glycemic thresholds for diabetes-specific retinopathy were observed over the range of 6.4-6.8 mmol/l for FPG, 9.8 -10.6 mmol/l for 2-h PG, and 6.3-6.7% for A1C. Thresholds for diabetes-specific retinopathy from receiver-operating characteristic curve analyses were 6.6 mmol/l for FPG, 13.0 mmol/l for 2-h PG, and 6.4% for A1C. CONCLUSIONS: This study broadens the evidence based on diabetes diagnostic criteria. A narrow threshold range for diabetes-specific retinopathy was identified for FPG and A1C but not for 2-h PG. The combined analyses suggest that the current diabetes diagnostic level for FPG could be lowered to 6.5 mmol/l and that an A1C of 6.5% is a suitable alternative diagnostic criterion. |
| first_indexed | 2025-11-14T06:09:02Z |
| format | Journal Article |
| id | curtin-20.500.11937-5863 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T06:09:02Z |
| publishDate | 2011 |
| publisher | American Diabetes Association |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-58632017-09-13T14:42:52Z Glycemic thresholds for diabetes-specific retinopathy: Implications for diagnostic criteria for diabetes Colagiuri, S. Lee, Crystal Wong, T. Balkau, B. Shaw, J. Borch-Johnsen, K. OBJECTIVE :To re-evaluate the relationship between glycemia and diabetic retinopathy. RESEARCH DESIGN AND METHODS: We conducted a data-pooling analysis of nine studies from five countries with 44,623 participants aged 20-79 years with gradable retinal photographs. The relationship between diabetes-specific retinopathy (defined as moderate or more severe retinopathy) and three glycemic measures (fasting plasma glucose [FPG; n = 41,411], 2-h post oral glucose load plasma glucose [2-h PG; n=21,334], and A1C [n=28,010]) was examined. RESULTS: When diabetes-specific retinopathy was plotted against continuous glycemic measures, a curvilinear relationship was observed for FPG and A1C. Diabetes-specific retinopathy prevalence was low for FPG <6.0 mmol/l and A1C <6.0% but increased above these levels. Based on vigintile (20 groups with equal numbers) distributions, glycemic thresholds for diabetes-specific retinopathy were observed over the range of 6.4-6.8 mmol/l for FPG, 9.8 -10.6 mmol/l for 2-h PG, and 6.3-6.7% for A1C. Thresholds for diabetes-specific retinopathy from receiver-operating characteristic curve analyses were 6.6 mmol/l for FPG, 13.0 mmol/l for 2-h PG, and 6.4% for A1C. CONCLUSIONS: This study broadens the evidence based on diabetes diagnostic criteria. A narrow threshold range for diabetes-specific retinopathy was identified for FPG and A1C but not for 2-h PG. The combined analyses suggest that the current diabetes diagnostic level for FPG could be lowered to 6.5 mmol/l and that an A1C of 6.5% is a suitable alternative diagnostic criterion. 2011 Journal Article http://hdl.handle.net/20.500.11937/5863 10.2337/dc10-1206 American Diabetes Association unknown |
| spellingShingle | Colagiuri, S. Lee, Crystal Wong, T. Balkau, B. Shaw, J. Borch-Johnsen, K. Glycemic thresholds for diabetes-specific retinopathy: Implications for diagnostic criteria for diabetes |
| title | Glycemic thresholds for diabetes-specific retinopathy: Implications for diagnostic criteria for diabetes |
| title_full | Glycemic thresholds for diabetes-specific retinopathy: Implications for diagnostic criteria for diabetes |
| title_fullStr | Glycemic thresholds for diabetes-specific retinopathy: Implications for diagnostic criteria for diabetes |
| title_full_unstemmed | Glycemic thresholds for diabetes-specific retinopathy: Implications for diagnostic criteria for diabetes |
| title_short | Glycemic thresholds for diabetes-specific retinopathy: Implications for diagnostic criteria for diabetes |
| title_sort | glycemic thresholds for diabetes-specific retinopathy: implications for diagnostic criteria for diabetes |
| url | http://hdl.handle.net/20.500.11937/5863 |