Progression of Diabetic Retinopathy After Initiation of Automated Insulin Delivery System in Adults With Type 1 Diabetes.

IF 3.7 Q2 ENDOCRINOLOGY & METABOLISM Journal of Diabetes Science and Technology Pub Date : 2025-02-14 DOI:10.1177/19322968251318740

Kagan E Karakus, Halis K Akturk, Janet K Snell-Bergeon, Viral N Shah

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Abstract

Background: To evaluate the progression of diabetic retinopathy (DR) after the initiation of automated insulin delivery (AID) systems in adults with type 1 diabetes (T1D).

Methods: In this longitudinal study with 152 adults, retinal exams and clinical variables were collected before and after AID initiation up to 2.7 years. The DR worsening was defined as an increase in Early Treatment of Diabetic Retinopathy Study (ETDRS) scores or qualitative retinal exam.

Results: A total of 152 adults with mean age of 42 years (57% female), 26 years of T1D duration, and mean baseline HbA_1c of 7.6% (60 mmol/mol) were included in this analysis. Of 152 adults with T1D, 42 (28%) adults had DR worsening after AID initiation. After adjusting for age, diabetes duration, and sex, baseline HbA_1c (odds ratio [OR] = 2.1 [1.34-3.04]) and low-density lipoprotein cholesterol (LDL-C) >100 mg/dL with HbA_1c >8% (OR = 3.33 [1.12-9.91]) were associated with two- and three-fold increased risk for DR worsening, respectively. The decline of HbA_1c with AID initiation between DR worsening and no-DR worsening groups was not significant (-0.38 ± 1.2% vs -0.47 ± 0.9%; P = .6).

Conclusions: Higher baseline HbA_1c with LDL-C >100 mg/dL may be associated with DR worsening after initiation of AID systems in T1D. Those with elevated HbA_1c should get periodic ophthalmic examination after AID initiation to detect progression of DR. Prompt diagnosis may result in timely treatment.

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成人1型糖尿病患者自动胰岛素输送系统启动后糖尿病视网膜病变的进展

背景：评估成人1型糖尿病（T1D）患者启动自动胰岛素输送（AID）系统后糖尿病视网膜病变（DR）的进展。方法：在这项对152名成年人进行的纵向研究中，收集了AID开始前后长达2.7年的视网膜检查和临床变量。DR恶化的定义为糖尿病视网膜病变早期治疗研究（ETDRS）评分或定性视网膜检查的增加。结果：共有152名成年人，平均年龄42岁（57%为女性），T1D病程26年，平均基线HbA1c为7.6% （60 mmol/mol）。在152例T1D患者中，42例（28%）在AID启动后出现DR恶化。在调整年龄、糖尿病病程和性别后，基线HbA1c（比值比[OR] = 2.1[1.34-3.04]）和低密度脂蛋白胆固醇(LDL-C) >100 mg/dL, HbA1c >8% （OR = 3.33[1.12-9.91]）分别与DR恶化风险增加2倍和3倍相关。DR恶化组和无DR恶化组的HbA1c在AID开始时的下降不显著(-0.38±1.2% vs -0.47±0.9%；P = .6)。结论：较高的基线HbA1c和LDL-C低于100 mg/dL可能与T1D患者AID系统启动后DR恶化有关。对于HbA1c升高的患者，AID开始后应定期眼科检查dr的进展情况，及时诊断可及时治疗。

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来源期刊

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.