Acta diabetologica · 2026
HbA1c variability as an independent risk factor for diabetic retinopathy: results from a screening program.
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Maiorino Maria Ida, Gesualdo Carlo, Angelino Silvia, Rossi Settimio, Di Martino Nicole, Iodice Clemente, Longo Miriam, Scappaticcio Lorenzo, Bellastella Giuseppe, Simonelli Francesca, Esposito Katherine
Аннотация
AIMS: To investigate the independent association between long-term glycemic variability, measured as the coefficient of variation (CV) of HbA1c, and the presence of diabetic retinopathy (DR) in a cohort of adults with diabetes within a systematic eye screening program.
METHODS: This study screened 379 adults with type 1 and type 2 diabetes. Long-term glycemic variability was calculated as the CV of serial HbA1c measurements. DR was assessed via dilated fundus photography. The association between HbA1c CV and DR was analyzed using multivariable logistic regression adjusting for confounders.
RESULTS: DR incidence of 12.4%, mostly mild non-proliferative. The median HbA1c CV was 7.0% (53 mmol/mol). In unadjusted bivariate analysis, the incidence of mild DR was higher in the low- glycemic variability group (CV < 5%) compared to the high- glycemic variability group. However, the multivariable logistic regression analysis revealed that higher HbA1c CV was independently associated with the presence of DR (β = 0.643, P = 0.042), alongside diabetes duration (P < 0.001) and age (P < 0.001).
CONCLUSIONS: In conclusion, in a cohort of individuals with both type 1 and type 2 diabetes and a low incidence of DR, long-term glycemic variability, estimated as HbA1c CV, was independently associated with an increased risk of this complication.
METHODS: This study screened 379 adults with type 1 and type 2 diabetes. Long-term glycemic variability was calculated as the CV of serial HbA1c measurements. DR was assessed via dilated fundus photography. The association between HbA1c CV and DR was analyzed using multivariable logistic regression adjusting for confounders.
RESULTS: DR incidence of 12.4%, mostly mild non-proliferative. The median HbA1c CV was 7.0% (53 mmol/mol). In unadjusted bivariate analysis, the incidence of mild DR was higher in the low- glycemic variability group (CV < 5%) compared to the high- glycemic variability group. However, the multivariable logistic regression analysis revealed that higher HbA1c CV was independently associated with the presence of DR (β = 0.643, P = 0.042), alongside diabetes duration (P < 0.001) and age (P < 0.001).
CONCLUSIONS: In conclusion, in a cohort of individuals with both type 1 and type 2 diabetes and a low incidence of DR, long-term glycemic variability, estimated as HbA1c CV, was independently associated with an increased risk of this complication.