Intensive diabetes management is believed to protect against diabetic retinopathy, yet the specific roles of glucose, blood pressure, and lipid control independent of high insulin exposure or severe hypoglycemia remain unclear. To better understand these factors, a detailed secondary analysis evaluated how intensified multifactorial therapy influenced the onset and progression of retinopathy in a cohort of 2,540 adults with type 2 diabetes. Over a median period of 8.5 years, intensive therapy reduced the risk of developing retinopathy (hazard ratio [HR] 0.83), though it did not affect progression (HR 1.02).
Higher HbA1c levels at one year increased onset risk (HR 1.31) with no clear threshold. The study also showed that even occasional hypoglycemic episodes raised risk (HR 1.25), while more frequent episodes carried an even greater risk (HR 1.85). These findings suggest that strict…
