Hyperglycemia, through several complex physiologic mechanisms, is thought to be the principal cause of the microvascular damage seen in diabetic retinopathy (DR) [1,2]. Consequently, several studies have demonstrated the importance of maintaining a normal or near-normal glycemic status in patients with DR [3–6]. Additionally, there are data suggesting that hypertension, a common comorbidity with diabetes mellitus, may exacerbate the microvascular damage caused by hyperglycemia [7]. Therefore, it is generally accepted that blood pressure control is also warranted for diabetic patients with retinopathy [4–6]. Currently, the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) [8,9] suggest that reasonable goals for glycated hemoglobin (HbA1c) and blood pressure (BP) in non-pregnant adult patients with diabetes are:
• HbA1c<7%; and
• BP<140/80mmHg
Comprehensive care for the diabetic patient should include, at minimum, an annual dilated eye exam; an eye care professional will determine if more frequent exams are necessary. During pregnancy, diabetic retinopathy can worsen and extra ophthalmologic screening is required.
For women with pre-existing diabetes who become pregnant, the ADA currently suggests an HbA1c goal of <6%, if it can be achieved without excessive hypoglycemia [8].
07-16-2015 | Retinopathy | Article