A new study reveals that intensive management of type 1 diabetes can significantly reduce the risk of having a diabetes-related eye surgery by nearly a whopping 50 percent. The blood sugar targets set for this study participants were quite stringent. But, even for people who couldn’t meet the target, it was observed that even a 10 percent improvement in hemoglobin A1C—a three-month estimate of average blood sugar levels led to around 35 percent reduction in the risk of diabetes-related eye surgery, as per the study.
Results of the research are published in the April 30 issue of the New England Journal of Medicine.
Dr. David Nathan, study’s senior author, director of the Massachusetts General Hospital Diabetes Center and Clinical Research Center in Boston said through this study they aim to show how a modest period of tight blood sugar control can lower the need for eye surgery.
Type 1 diabetes is an autoimmune disease that destroys the body’s ability to produce insulin. Typically, the A1C goal for people with this disease is under 7 perfect. So, if one can bring it down to 7 from 7.7 or from 8.5 to 7.7 – it would lead to a 35% reduction in diabetes related eye procedures. A lower A1C is definitely better, as long as it is achieved as safely as possible.
It is not good to lower blood sugar too much too fast. Also, elevated blood sugar levels for a long time can lead to long term health consequences which include eye issues.
Diabetes destroys eyes in several ways Nathan explains. Even though our eyes balls are tiny when compared to the whole body, the eyes have enormous blood flow through very fine, small caliber vessels. Abnormalities like breakage of these vessels causing blood leakage can develop in these vessels due to persistently high sugar levels. Such problems in the eye vessels can lead to a condition called macular edema and diabetic retinopathy. Another problem diabetics face is they tend to develop cataract about a decade earlier in life.
For this research two studies were included and encompassed about 1400 people with type 1 diabetes. The first study dates back to 1980s and had two groups of people—one that received intensive diabetes management, while the other group received standard care. It lasted about 10 years. The second study followed most of the people from the initial study over the long term, though the intensive management stopped.
For the first study, it was aimed to get the A1C to 6.05. However, the average A1C ended up at 7 percent. In the 23 years that followed, 63 people out of 711 who were under intensive management underwent diabetes-related eye surgery while 98 of the 730 people in the standard therapy group had diabetes-related eye surgery. Also, people in the intensive therapy group, had a 48% lower risk of cataract surgery. It was also noted that the costs of diabetes-related eye surgeries were 32 percent less for the group that received intensive management.
Helen Nickerson, director of translational development for JDRF said that interventions to control glucose levels can improve outcomes, preserve life and prevent disabilities.
Type 1 diabetes is prevalent worldwide with close to 38 million people suffering from it. The study authors opined that intensive therapy can benefit them and reduce morbidity and health care costs. This study didn’t include people suffering from type 2 diabetes whose estimated number is 10-20 times higher than type 1 diabetes. But, as per the evidences from previous research it is seen that people with type 1 diabetes are slightly more likely to have eye disease.