By Colin Kenny, GP, Dromore
The original ACCORD Study (2003–2009) randomised 10,251 participants with type 2 diabetes to have intensive or standard treatment for hyperglycaemia. The study was controversial as there was a higher observed death rate in the intensive treatment arm compared with the standard glycaemic control arm. In the ACCORD Follow-On Eye Study, a subgroup of 2856 participants had baseline and yearly eye examinations and fundus photographs.
Diabetic retinopathy progressed in 5.8% of participants who had been in the intensive glycaemic treatment arm and 12.7% from the standard treatment arm. The investigators concluded that prior intensive glycaemic control continued to reduce diabetic retinopathy progression, despite similar HbA1c levels, after the ACCORD Study ended. This is the first study in people with type 2 diabetes of 10 years’ duration and established cardiovascular disease that has demonstrated this effect.
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