The study aimed to examine how fluctuations in HbA1c levels between medical visits affected the development and progression of diabetic retinopathy (DR).

This retrospective study examined data from 5,898 patients with type 2 diabetes mellitus (T2DM) who had follow-up information on their eye health. The visit-to-visit variability of HbA1c levels over seven years (2014-2020) was assessed using the intrapersonal coefficient of variation (CV) of HbA1c. Patients were categorized into two groups at the start of the study: those diagnosed without diabetic retinopathy (non-DR) and those diagnosed with diabetic retinopathy (DR). DR was classified according to the Davis classification. Data analyses were conducted using SPSS version 29.0 software.

Data from 4,197 patients with non-diabetic retinopathy (non-DR) and 1,701 patients with diabetic retinopathy (DR) were analyzed. The multivariate logistic regression analyses found no significant association between the coefficient of variation (CV) of HbA1c and the development of DR. However, HbA1c levels (OR=1.37), pulse pressure (OR=1.04), and longer diabetes duration (OR=1.02) were significantly associated with an increased risk of developing DR. Additionally, there was a significant association between CV of HbA1c and the progression of DR (OR=1.04).

The study indicated that HbA1c levels, pulse pressure, and the duration of diabetes were linked to the development of diabetic retinopathy (DR). However, the visit-to-visit variability in HbA1c levels did not influence DR development. In contrast, the progression of DR was associated with the visit-to-visit variability in HbA1c levels. Therefore, monitoring the visit-to-visit variability in HbA1c might serve as a new marker for tracking the progression of diabetic retinopathy.

13-OR: American Diabetes Association (ADA) 84th Scientific Sessions, 2024, 21- 24 June 2024, Orlando, Florida.