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Glycemic thresholds for diabetes-specific retinopathy: implications for diagnostic criteria for diabetes.

Publication ,  Journal Article
Colagiuri, S; Lee, CMY; Wong, TY; Balkau, B; Shaw, JE; Borch-Johnsen, K; DETECT-2 Collaboration Writing Group,
Published in: Diabetes Care
January 2011

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.

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Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

January 2011

Volume

34

Issue

1

Start / End Page

145 / 150

Location

United States

Related Subject Headings

  • Young Adult
  • Middle Aged
  • Humans
  • Glycated Hemoglobin
  • Fasting
  • Endocrinology & Metabolism
  • Diabetic Retinopathy
  • Blood Glucose
  • Aged
  • Adult
 

Citation

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Colagiuri, S., Lee, C. M. Y., Wong, T. Y., Balkau, B., Shaw, J. E., Borch-Johnsen, K., & DETECT-2 Collaboration Writing Group, . (2011). Glycemic thresholds for diabetes-specific retinopathy: implications for diagnostic criteria for diabetes. Diabetes Care, 34(1), 145–150. https://doi.org/10.2337/dc10-1206
Colagiuri, Stephen, Crystal M. Y. Lee, Tien Y. Wong, Beverley Balkau, Jonathan E. Shaw, Knut Borch-Johnsen, and Knut DETECT-2 Collaboration Writing Group. “Glycemic thresholds for diabetes-specific retinopathy: implications for diagnostic criteria for diabetes.Diabetes Care 34, no. 1 (January 2011): 145–50. https://doi.org/10.2337/dc10-1206.
Colagiuri S, Lee CMY, Wong TY, Balkau B, Shaw JE, Borch-Johnsen K, et al. Glycemic thresholds for diabetes-specific retinopathy: implications for diagnostic criteria for diabetes. Diabetes Care. 2011 Jan;34(1):145–50.
Colagiuri, Stephen, et al. “Glycemic thresholds for diabetes-specific retinopathy: implications for diagnostic criteria for diabetes.Diabetes Care, vol. 34, no. 1, Jan. 2011, pp. 145–50. Pubmed, doi:10.2337/dc10-1206.
Colagiuri S, Lee CMY, Wong TY, Balkau B, Shaw JE, Borch-Johnsen K, DETECT-2 Collaboration Writing Group. Glycemic thresholds for diabetes-specific retinopathy: implications for diagnostic criteria for diabetes. Diabetes Care. 2011 Jan;34(1):145–150.

Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

January 2011

Volume

34

Issue

1

Start / End Page

145 / 150

Location

United States

Related Subject Headings

  • Young Adult
  • Middle Aged
  • Humans
  • Glycated Hemoglobin
  • Fasting
  • Endocrinology & Metabolism
  • Diabetic Retinopathy
  • Blood Glucose
  • Aged
  • Adult