Patients with type 1 diabetes who received an average of 6.5 years of intensive diabetes therapy reduced their long-term risk of undergoing one or more diabetes-related ocular procedures by 48% (P < .001) and reduced total operations in either eye by 37% (P = .01), compared with those receiving conventional diabetes therapy, after adjusting for confounding risk factors, according to a report by Dr. Lloyd Paul Aiello of the Beetham Eye Institute, Joslin Diabetes Center, Boston, and other members of the DCCT/EDIC Research Group.
To evaluate the effect of intensive therapy on the incidence and cost of ocular surgery, 1,441 patients with type 1 diabetes were split into two groups and randomly assigned to receive either intensive diabetes therapy (aimed at lowering serum glucose as close to the nondiabetic range as safely possible) or conventional therapy (aimed at preventing symptoms of hyperglycemia and hypoglycemia, but without specific glucose targets). The patients’ elf-reported histories of ocular surgical procedures were gathered between 1983 and 1989, with a median of 23 years of follow-up.
In addition, the inflation-adjusted costs of eye surgeries (including cataract extraction, vitrectomy, and glaucoma-related operations) were 32% lower in the intensive-therapy group than in the conventional-therapy group.
“Reduced glycated hemoglobin levels account for essentially all the benefits of intensive therapy versus conventional therapy, and these results highlight the importance of early, intensive diabetes control,” the investigators wrote.
Read the full article here: (N. Engl. J. Med 2015;372:1722-33 [doi:10.1056/NEJMoa1409463]).