title: A five-year prospective study of diabetic retinopathy progression in chinese type 2 diabetes patients with "well-controlled" blood glucose.
abstract: OBJECTIVE
  To determine the progression rate and risk factors for diabetic retinopathy (DR) in Chinese type 2 diabetic patients who have reached the target hemoglobin A1c (HbA1c) level recommended by the American Diabetes Association.
  
  
  METHODS
  This was a 5-year community-based prospective study. The study population consisted of patients with type 2 diabetes with HbA1c less than 7.0%. Demographic information, systemic examination results and ophthalmological test results for each participant were collected. The outcome of this study was the progression of DR, which was defined as an increase in DR grade in one or both eyes at the final visit in comparison to the baseline status. The association between each potential risk factor and DR progression was studied.
  
  
  RESULTS
  A total of 453 patients with HbA1c less than 7.0% were included in the study group. In 146 patients (32.22%), DR developed or progressed during the five-year follow-up. Baseline HbA1c level was the only independent risk factor for DR progression (p<0.01, OR = 2.84, 95%CI: 2.11~3.82). The logistic regression function suggested that the possibility of DR progression increased fastest when baseline HbA1c increased from 5.2% to 6.4%. The 5-year DR progression rate in patients with baseline HbA1c less than 5.2%, between 5.2% and 6.4%, and over 6.4% were 19.62%, 24.41%, and 76.83%, respectively.
  
  
  CONCLUSIONS
  To slow the progression of DR in Chinese patients with type 2 diabetes, more intensive glucose control is recommended.
authors: Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 20080, China.
authors: Peiyao
authors: P
authors: Jin
authors: Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 20080, China.
authors: Jinjuan
authors: J
authors: Peng
authors: Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 20080, China; Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, 200040, China.
authors: Haidong
authors: H
authors: Zou
authors: Beixinjing Community Health Service Center, Shanghai, China.
authors: Weiwei
authors: W
authors: Wang
authors: Beixinjing Community Health Service Center, Shanghai, China.
authors: Jiong
authors: J
authors: Fu
authors: Beixinjing Community Health Service Center, Shanghai, China.
authors: Binjie
authors: B
authors: Shen
authors: Beixinjing Community Health Service Center, Shanghai, China.
authors: Xuelin
authors: X
authors: Bai
authors: Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 20080, China.
authors: Xun
authors: X
authors: Xu
authors: Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 20080, China.
authors: Xi
authors: X
authors: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin