Weight loss, bariatric surgery, and novel antidiabetic drugs effects on diabetic retinopathy: a review.

IF 3 2区医学 Q1 OPHTHALMOLOGY Current Opinion in Ophthalmology Pub Date : 2024-05-01 Epub Date: 2024-01-30 DOI:10.1097/ICU.0000000000001038

Alejandro M Perez, Emily Neag, Jayanth Sridhar, Basil K Williams

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Abstract

Purpose of review: Diabetic retinopathy (DR) is a leading cause of visual impairment, and the increasing prevalence of diabetes and obesity will impact rates of visual impairment moving forward. Our review aims to synthesize the current body of evidence regarding the impact of lifestyle interventions, such as weight loss, bariatric surgery, and novel antidiabetic drugs, on DR.

Recent findings: Literature review revealed insufficient evidence regarding the impact of weight loss on DR. Preoperative DR patients undergoing bariatric surgery were found to have similar short-term chances of improvement or worsening DR. Progression of DR with glucagon-like peptide 1 receptor agonists treatments appears unrelated to specific drugs and was also observed with traditional antidiabetic medications.

Summary: Rapidly correcting HbA1c levels (≥2%) can paradoxically lead to early worsening DR. Patients considering weight loss, bariatric surgery, and novel antidiabetic drugs should be aware of the potential for DR progression, but they should not be discouraged, as achieving glycemic control is essential for reducing long-term morbidity and mortality from other diabetes-related complications. It is advisable to conduct a baseline retinal examination before treatment and continue monitoring during therapy. Further research is needed to understand the long-term effects of these treatments on DR.

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减肥、减肥手术和新型抗糖尿病药物对糖尿病视网膜病变的影响：综述。

综述的目的：糖尿病视网膜病变（DR）是视力损伤的主要原因之一，糖尿病和肥胖症发病率的增加将影响视力损伤率。我们的综述旨在综合目前有关生活方式干预（如减肥、减肥手术和新型抗糖尿病药物）对糖尿病视网膜病变影响的证据：文献综述显示，有关减肥对 DR 影响的证据不足。研究发现，术前接受减肥手术的 DR 患者短期内 DR 改善或恶化的几率相似。胰高血糖素样肽 1 受体激动剂治疗导致的 DR 进展似乎与特定药物无关，传统的抗糖尿病药物也会导致 DR 进展：摘要：快速纠正 HbA1c 水平（≥2%）可能会导致 DR 早期恶化。考虑减重、减肥手术和新型抗糖尿病药物的患者应意识到 DR 进展的可能性，但不应因此而气馁，因为实现血糖控制对于降低其他糖尿病相关并发症的长期发病率和死亡率至关重要。建议在治疗前进行基线视网膜检查，并在治疗期间继续监测。要了解这些疗法对 DR 的长期影响，还需要进一步的研究。

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来源期刊

Current Opinion in Ophthalmology 医学-眼科学

CiteScore

6.80

自引率

5.40%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Ophthalmology is an indispensable resource featuring key up-to-date and important advances in the field from around the world. With renowned guest editors for each section, every bimonthly issue of Current Opinion in Ophthalmology delivers a fresh insight into topics such as glaucoma, refractive surgery and corneal and external disorders. With ten sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, clinicians and other healthcare professionals alike.