Association of Blood Glucose Control and Lipids With Diabetic Retinopathy in the Veterans Affairs Diabetes Trial (VADT) Journal Article


Authors: Azad, N; Bahn, G. D.; Emanuele, N. V.; Agrawal, L; Ge, L; Reda, D; Klein, R.; Reaven, P. D.; Hayward, R.; VADT Study Group
Article Title: Association of Blood Glucose Control and Lipids With Diabetic Retinopathy in the Veterans Affairs Diabetes Trial (VADT)
Abstract: OBJECTIVE: This study examined whether lipids modify the relationship between intensive glucose control (INT) and diabetic retinopathy (DR). RESEARCH DESIGN AND METHODS: The incidence and progression of DR were assessed in 858 of 1,791 participants with 7-field stereoscopic fundus photographs at baseline and 5 years later. RESULTS: Odds of DR progression were lower by approximately 40% in those with baseline total cholesterol (TC) >/=200 mg/dL (P = 0.007), LDL-C >/=120 mg/dL (P /=40 mg/dL (P /=40 mg/dL (P /=40 mg/dL (P /=40 mg/dL (P /=45 mg/dL (P = 0.01) at the fifth year. Odds of DR progression were lower by approximately 40-50% with reductions of TC by >/=40 mg/dL (P /=40 mg/dL (P /=60 mg/dL (P = 0.004) at the fifth year. Odds of DR progression increased by 80% with increases in TC of >/=20 mg/dL (P /=60 mg/dL (P 0.004). After adjusting for covariants, those with higher TC at baseline and lower TC during and at the fifth year and higher HDL-C throughout study had significantly decreased odds of DR progression in INT. CONCLUSIONS: INT was associated with decreased odds of progression but not with onset of retinopathy in those with worse lipid levels at baseline and more improved lipid levels during the study. Higher HDL-C was consistently associated with better response to INT throughout the study.
Journal Title: Diabetes care
ISSN: 1935-5548; 0149-5992
Publisher: by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered  
Date Published: 2016
Language: ENG
DOI/URL:
Notes: LR: 20160324; CI: (c) 2016; JID: 7805975; 2015/08/31 [received]; 2016/01/21 [accepted]; aheadofprint