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Master Thesis

Rétinopathie diabétique chez les patients diabétiques de type 2 bien contrôlés: rôle de la mémoire glycémique

Abstract : Aims: as diabetic retinopathy (DR) can occur even in well-controlled patients with type 2 diabetes (T2D), our study sought to determine whether it might be related to ‘glucose memory‘ by evaluating patients’ HbA1c over previous years and their skin autofluorescence (SAF). Methods: in 334 patients with T2D and HbA1c levels ≤ 8%, their available values of HbA1c from previous years were collected, and their SAF measured by an advanced glycation end-product (AGE) reader. Binary logistic regression analysis was then used to correlate DR with previously recorded HbA1c levels and to SAF, with adjustment for DR risk factors [age, gender, BMI, duration of diabetes, arterial hypertension, diabetic kidney disease (DKD), blood lipid levels and statin treatment] Results: our patients were mostly men (58.4%) aged 63 ± 10 years, with a duration of diabetes of 13 ± 10 years and HbA1c = 7.1 ± 0.7%. Of these patients, 84 (25.1%) had DR, which was associated with longer duration of diabetes and greater prevalence of DKD. A total of 605 HbA1c values from previous years were collected for time periods -4 ± 3 months (n = 255), -16 ± 4 months (n = 152), -30 ± 4 months (n = 93) and -62 ± 26 months (n = 105). After adjustment, the association between DR and having an HbA1c higher than the median was significant only for the oldest previous HbA1c values: OR = 6.75, 95% CI: 1.90–23.90. Moreover, SAF values were higher in those with DR [2.95 ± 0.67 arbitrary units (AU)] vs 2.65 ± 0.65 AU with no DR (P < 0.01) and were also associated with the oldest previous HbA1c values (P < 0.01). Conclusion: our study found that 25.1% of our well-controlled T2D patients had DR, which was related to both their HbA1c levels from 5 years prior to study admission and their SAF values, a marker of glucose memory.
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https://dumas.ccsd.cnrs.fr/dumas-03065969
Contributor : Médecine Ub <>
Submitted on : Tuesday, December 15, 2020 - 9:10:07 AM
Last modification on : Tuesday, January 26, 2021 - 3:10:16 AM
Long-term archiving on: : Tuesday, March 16, 2021 - 6:40:05 PM

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  • HAL Id : dumas-03065969, version 1

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Claire Ducos. Rétinopathie diabétique chez les patients diabétiques de type 2 bien contrôlés: rôle de la mémoire glycémique. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03065969⟩

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