First Author: G.Palexas UK
Co Author(s): O. Almossawi
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Elevated HbA1c is implicated in the disease process associated with miabetic maculopathy (DMO). To study the association between HbA1c and DMO.
Retrospective cohort study. Patients undergoing anti-VEGF therapy for DMO.
Routinely collected data between September 2015 and December 2016 were analysed. Patients with DMO admitted for intravitreal anti-VEGF therapy qualified for this treatment if central foveal thickness exceeded 400 micro-metres. Levels of HbA1c in unilateral versus bilateral DMO, previous laser treatment, and low versus high glycaemic control. Good glycaemic control was defined as HbA1c≤59mmol/mol.
There were 196 patients with mean age 64.9 years and mean HbA1c 70.13 mmol/mol, of which 120 (61%) were male, 71 (36%) had bilateral DMO, 117 (60%) had previous argon laser, 106 (54%) were Europeans, and equal numbers of Africans and Asians (23%). There was no difference in HbA1c in those with unilateral (69.0mmol/mol) versus bilateral (72.0mmol/mol) DMO, P=0.664, or in those with previous laser (69.7mmol/mol) versus no laser (70.7mmol/mol) for DMO, P=0.631. Sixty-five patients (33%) had good glycaemic control compared to 131 (67%) with poor control. There was a strong negative association between age and HbA1c, for each one year increase in age, HbA1c decreased by 0.5 mmol/mol (95% CI -0.75 to -0.28, P<0.001).
In this cohort of patients undergoing anti-VEGF therapy for DMO, the level of HbA1c at the time of treatment was not associated with bilaterality, or previous history of laser for DMO. There was an observation that HbA1c decreases with age by 0.5 mmol/year.