Effect of a Multifactorial Intervention on Retinopathy in People With Type 2 Diabetes

How does strict multifactorial intervention, with good glycemic management and a low incidence of severe hypoglycemia, affect the onset and progression of retinopathy in people with type 2 diabetes?In this secondary analysis of the J-DOIT3 randomized clinical trial, a multifactorial intervention and glycemic management were associated with a risk reduction in onset but not progression of retinopathy. No clear hemoglobin A threshold for onset of retinopathy was observed; hypoglycemia was associated with a higher risk of onset but not progression of retinopathy.These findings support the increasing importance of strict glycemic management without any hypoglycemia to increase the chance of preventing retinopathy.

Corresponding Authors: Kohjiro Ueki, MD, PhD, Diabetes Research Center, Japan Institute for Health Security, 1-21-2 Toyama, Shinjuku-Ku, Tokyo 162-8655, Japan (ueki.k@jihs.go.jp); Takashi Kadowaki, MD, PhD, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan (t-kadowaki@toranomon.kkr.or.jp).

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