DIABETES
CGM use associated with lower retinopathy risk in type 1 diabetes
A study carried out by researchers in the John Hopkins Endocrine and Diabetes Center in the US found that patients who used a CGM had lower odds of proliferative diabetic retinopathy than those who did not
April 6, 2024
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The use of continuous glucose monitoring (CGM) was linked to reduced risk for diabetic retinopathy and proliferative diabetic retinopathy in adults with type 1 diabetes, a recent retrospective cohort study has found.The study, conducted by researchers from the Endocrine and Diabetes Center at Johns Hopkips and the Wilmer Eye Institute in Baltimore, Maryland, reviewed electronic health records for adults with type 1 diabetes who were seen at both sites from 2013 to 2021.Researchers assessed the association between the use of diabetes technology — CGM, insulin pumps or both — and retinopathy risk in 550 patients (median age, 40 years; 54.4% women).During the 8-year period, 62.7% of patients used CGM; 58.2% used insulin pumps; and 47.5% used both.The primary outcome was the development of proliferative or nonproliferative diabetic retinopathy with or without macular edema.The secondary outcome was the progression of diabetic retinopathy in patients with more than one ophthalmology encounter.Overall, 44.4% of patients were diagnosed with diabetic retinopathy; 11.1% and 49.2% had nonproliferative diabetic retinopathy with and without macular edema, respectively, while 11.9% and 27.9% had proliferative diabetic retinopathy with and without macular edema, respectively.Patients who used CGM had lower odds of diabetic retinopathy (odds ratio, 0.52; P = .008) and lower odds of proliferative diabetic retinopathy (OR, 0.42; P = .004) than patients who did not use CGM.Insulin pump use alone did not show an association with diabetic retinopathy, but CGM and pump use together were associated with lower odds of proliferative diabetic retinopathy (OR, 0.60; P = .03) than no CGM or pump use.Among patients with more than one ophthalmology encounter who did not have a proliferative diabetic retinopathy diagnosis at baseline, only 21.8% experienced some progression of diabetic retinopathy.Microvascular complications (OR, 5.48; P < .001) and higher mean A1c levels (OR, 1.24; P = .03) were associated with the risk for diabetic retinopathy progression.The study was published in the JAMA Network Open.