ArticleScientific reports2021
Long-term HbA1c variability and the development and progression of diabetic retinopathy in subjects with type 2 diabetes.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Association between glycated hemoglobin variability and risk of diabetic kidney disease and diabetic retinopathy in diabetic patients: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Exploring leukocyte differential count ratio profiles as inflammatory biomarkers in diabetic retinopathy: a systematic review and meta-analysis.BMC ophthalmology · 2025Pooled it
- Pooled it
- Long-term HbA1c variability and macro-/micro-vascular complications in type 2 diabetes mellitus: a meta-analysis update.Acta diabetologica · 2023Pooled it
- HbA1c variability as an independent risk factor for diabetic retinopathy: results from a screening program.Acta diabetologica · 2026Article
- Incidence and predictors of diabetic retinopathy among patients with type 2 diabetes and hypertension: a 10-year retrospective follow-up study.Scientific reports · 2026Article
- Two-stage diagnostic intervals in diabetic retinopathy and associated factors: a cross-sectional study.BMC ophthalmology · 2026Article
- Diabetic retinopathy: why some eyes suffer more - a focus on retina-specific risk factors and metabolic memory.Journal of translational medicine · 2026Review
- The association between glycated hemoglobin and intraocular inflammatory factors in patients with proliferative diabetic retinopathy.International journal of retina and vitreous · 2025Article
- Diabetic retinal disease.Nature reviews. Disease primers · 2025Review
- Cluster Analysis in Diabetes Research: A Systematic Review Enhanced by a Cross-Sectional Study.Journal of clinical medicine · 2025Review
- Article
- Association Between Hormone Levels and Retinopathy in Patients With Type 2 Diabetes: A Cross-Sectional Study.Translational vision science & technology · 2025Article
- Article
- Cut-off value of glycated hemoglobin A1c for detecting diabetic retinopathy in the Chinese population.World journal of diabetes · 2024Article
- An interpretable predictive deep learning platform for pediatric metabolic diseases.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Comparative Analysis of Biomarkers in Type 2 Diabetes Patients With and Without Comorbidities: Insights Into the Role of Hypertension and Cardiovascular Disease.Biomarker insights · 2024Article
- What else can we do to prevent diabetic retinopathy?Diabetologia · 2023Article
- Time in range as a useful marker for evaluating retinal functional changes in diabetic retinopathy patients.International journal of ophthalmology · 2023Article
- HbA1c Variability and Cardiovascular Events in Patients with Prostate Cancer Receiving Androgen Deprivation Therapy.European urology open science · 2023Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study aimed to investigate whether long-term HbA1c variability is associated with the development and progression of diabetic retinopathy (DR) in subjects with type 2 diabetes. We retrospectively reviewed 434 type 2 diabetes subjects without DR who underwent regular DR screening. We reviewed fundus findings, collected HbA1c levels, and calculated the coefficient of variation (CV) and average real variability (ARV) of each subject's HbA1c level. DR was developed in 55 subjects and progressed to moderate nonproliferative DR or worse DR in 23 subjects. On Cox proportional hazards regression analysis, HbA1c ARV, but not HbA1c CV, was significantly associated with DR development. However, the association between HbA1c variability and the DR progression rate to moderate nonproliferative DR or worse DR was not significant. The inter-visit HbA1c difference value on consecutive examination predicted DR development well and more careful screening for DR is needed for those with an absolute value change of 2.05%, an absolute increase of 1.75%, and an absolute decrease of 1.45% in HbA1c levels on consecutive examination. These results indicate that long-term glucose variability measured by HbA1c ARV might be an independent risk factor for DR development in addition to the mean HbA1c level in early diabetic subjects.
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