Diabetes Self-Management Blog

Diabetic retinopathy, or eye disease, is a condition in which damaged blood vessels at the back of the eye leak fluids and abnormal new blood vessels develop, both potentially leading to vision loss. After having diabetes for 20 years, nearly everyone with Type 1 diabetes and more than 60% of people with Type 2 diabetes develop retinopathy. But results from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study has shown that two treatments — intensive blood glucose control and the use of a combination of cholesterol-lowering statin and fibrate drugs — may be able to slow the progression of this condition.

The ACCORD study involved 10,251 adults with Type 2 diabetes who were at particularly high risk of cardiovascular conditions. A subset of ACCORD, the ACCORD Eye Study involved 2,856 of these participants and sought to determine whether intensive blood glucose control, intensive blood pressure control, or intensive blood lipid (fat) control could slow the progression of diabetic retinopathy. Intensive blood glucose control was achieved using a combination of glucose-lowering medicines; people in the intensive control group had a median A1C level of 6.4%, compared to 7.5% in the standard control group. Intensive blood lipid control was attained by means of a combination of simvastatin (brand name Zocor) and fenofibrate (Tricor and others), compared to just a statin drug in the standard control group. Intensive blood pressure control was accomplished with the use of various blood-pressure-lowering medicines.

Evaluating the participants at 4 years after the start of the study, the researchers discovered that both the intensive blood glucose control and the intensive lipid control resulted in a roughly one-third reduction in the rate of progression of diabetic retinopathy. Intensive blood pressure control was not found to have any effect on the progression of the condition.

The researchers noted, however, that there were more deaths in the intensive-blood-glucose-lowering group of the ACCORD study. The arm of the trial using this treatment strategy was stopped 18 months early in 2008 as a result, and researchers have offered a few different explanations for why there were more deaths in this group.

According to study chairwoman Emily Chew, MD, “The ACCORD Eye Study clearly indicates that intensive glycemic control and fibrate treatment added to statin therapy separately reduce the progression of diabetic retinopathy. The main ACCORD findings showed that fibrate treatment added to statin therapy is safe for patients like those involved in the study.” However, she went on to note the increased risk of low blood glucose and the higher rate of death in the intensive-glucose-lowering arm of the study, suggesting that people with diabetes and their doctors “take these potential risks into account when implementing a diabetes plan.”

For more information, read the article “Eye Study Finds Two Therapies Slow Diabetic Eye Disease” or see the study in The New England Journal of Medicine. And to learn more about keeping your eyes healthy, click here.

POST A COMMENT       
  

Comments
  1. What were the differences in diet, medication, etc. between the intensive glucose control group and the standard group?

    Posted by Margot Critchfield |

Post a Comment

Note: All comments are moderated and there may be a delay in the publication of your comment. Please be on-topic and appropriate. Do not disclose personal information. Be respectful of other posters. Only post information that is correct and true to your knowledge. When referencing information that is not based on personal experience, please provide links to your sources. All commenters are considered to be nonmedical professionals unless explicitly stated otherwise. Promotion of your own or someone else's business or competing site is not allowed: Sharing links to sites that are relevant to the topic at hand is permitted, but advertising is not. Once submitted, comments cannot be modified or deleted by their authors. Comments that don't follow the guidelines above may be deleted without warning. Such actions are at the sole discretion of DiabetesSelfManagement.com. Comments are moderated Monday through Friday by the editors of DiabetesSelfManagement.com. The moderators are employees of Madavor Media, LLC., and do not report any conflicts of interest. A privacy policy setting forth our policies regarding the collection, use, and disclosure of certain information relating to you and your use of this Web site can be found here. For more information, please read our Terms and Conditions.


Eyes & Vision
Focus on This: May Is Healthy Vision Month (05/14/13)
Drug Improves Vision in Diabetic Retinopathy (11/30/12)
Diabetes and Your Eyes — More Than Retinopathy (05/24/13)
FDA Approves Drug for Diabetes-Related Vision Loss (08/24/12)

Diabetic Complications
Statins May Reduce Risk of Nerve Damage, Other Diabetes Complications (09/18/14)
New Approach for Neuropathy Pain? (08/18/14)
Study Evaluating Treatment for Neuropathy Pain (07/08/14)
Good Control Now = Lifetime Benefit (06/25/14)

Diabetes Research
Can Grapefruit Juice Prevent Weight Gain, Increase Insulin Sensitivity? (10/16/14)
Low-Carb Diet Improves Quality of Life in Type 2 Diabetes (10/07/14)
Long Hours at Low-Income Jobs Linked to Increased Diabetes Risk (10/02/14)
Statins May Reduce Risk of Nerve Damage, Other Diabetes Complications (09/18/14)

Diabetes News
Can Grapefruit Juice Prevent Weight Gain, Increase Insulin Sensitivity? (10/16/14)
Low-Carb Diet Improves Quality of Life in Type 2 Diabetes (10/07/14)
Long Hours at Low-Income Jobs Linked to Increased Diabetes Risk (10/02/14)
New Weekly Type 2 Diabetes Drug Approved (09/26/14)

Diane Fennell
Take Part in the Big Blue Test! (10/15/14)
Can Grapefruit Juice Prevent Weight Gain, Increase Insulin Sensitivity? (10/16/14)
Low-Carb Diet Improves Quality of Life in Type 2 Diabetes (10/07/14)
Long Hours at Low-Income Jobs Linked to Increased Diabetes Risk (10/02/14)

 

 

Disclaimer of Medical Advice: You understand that the blog posts and comments to such blog posts (whether posted by us, our agents or bloggers, or by users) do not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs. The opinions and other information contained in the blog posts and comments do not reflect the opinions or positions of the Site Proprietor.


Blood Glucose Self-Monitoring — Part 3: Smart Monitoring

10 Keys to Long-Term Weight Loss

Take Your Best Shot: Stay Up to Date on Vaccines

Complete table of contents
Get a FREE ISSUE
Subscription questions