Results from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study suggest that intensive glycemic control and a combination of cholesterol-lowering medications reduce the rate of retinopathy progression in patients with type 2 diabetes. The study was published in the June 29 issue of the New England Journal of Medicine.
Researchers from the ACCORD Eye Study followed 2,856 subjects for four years to determine whether intensive glycemic control, combination therapy for dyslipidemia (fenofibrate and simvastatin) and/or rigorous blood-pressure control would limit the progression of diabetic retinopathy in patients with type 2 diabetes mellitus.
At four years, 7.3% of patients in the intensive glycemic control group experienced retinopathy progression vs. 10.4% of those on standard glycemic control, and 6.5% of patients in the combination dyslipidemia therapy group experienced progression vs. 10.2% of those who took a placebo. However, 10.4% of patients in the rigorous blood pressure therapy group demonstrated retinopathy progression vs. just 8.8% of patients on conventional blood pressure therapy.
“The ACCORD Eye Study clearly indicates that intensive glycemic control and fibrate treatment added to statin therapy separately reduce the progression of diabetic retinopathy,” says Emily Chew, M.D., chair of the Eye Study and chief of the Clinical Trials Branch of the Division of Epidemiology and Clinical Applications at the National Eye Institute. “The main ACCORD findings showed that fibrate treatment added to statin therapy is safe for patients like those involved in the study. However, intensive blood sugar control to near normal glucose levels increased the risk of death and severe low blood sugar, so patients and their doctors must take these potential risks into account when implementing a diabetes treatment plan.”
ACCORD Study Group; ACCORD Eye Study Group, Chew EY, Ambrosius WT, Davis MD, et al. Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med. 2010 Jul 15;363(3):233-44.