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Intensive T1DM Control Greatly Lowers Odds of Ocular Surgery

Even modest period of tight control can lower need for eye surgery

THURSDAY, April 30, 2015 (HealthDay News) -- Intensive management of type 1 diabetes can reduce the risk of having a diabetes-related ocular surgery by nearly 50 percent, according to a new report. Results of the study were published in the April 30 issue of the New England Journal of Medicine.

The new research included two studies involving 1,441 patients with type 1 diabetes. The first study from the early 1980s had two groups of patients -- one that received intensive diabetes management, while the other group received standard care. That study lasted about 10 years. The second study followed most of the patients (1,375) from the initial study over the long term, though the intensive management stopped. "In the initial study, the goal was to get the A1C to 6.05," senior author, David Nathan, M.D., director of the Massachusetts General Hospital Diabetes Center and Clinical Research Center in Boston, told HealthDay, adding that the average A1C ended up being 7 percent.

During the 23-year follow-up, 63 patients out of 711 receiving intensive management ended up having diabetes-related ocular surgery. Ninety-eight of the 730 patients in the conventional therapy group had diabetes-related ocular surgery. For the intensive therapy group, the risk of needing cataract surgery was 48 percent lower. The risk of vitrectomy or retinal-detachment surgery -- or both surgeries -- was reduced 45 percent in the intensive management group.

The costs of diabetes-related ocular surgeries were 32 percent less for the group that received intensive management -- $429,000 versus $635,000, according to the authors.

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