Diabetic retinopathy in type 2 diabetes can significantly impair vision and quality of life, yet the relative impact of intensive glycemic control, hypoglycemia, and multifactorial interventions remains uncertain due to inconsistent evidence from prior trials. To address this gap, the study evaluated the effects of intensive multifactorial intervention and hypoglycemia on the onset and progression of retinopathy in 2540 individuals (5080 eyes) with type 2 diabetes. The study found that intensive therapy significantly reduced the onset of diabetic retinopathy (hazard ratio (HR) 0.83) but had no effect on its progression (HR 1.02).
Higher HbA1c levels at 1 year were associated with increased risk of onset (HR 1.31), with no clear threshold observed. Additionally, compared to no hypoglycemia, the risk of onset was higher with ≤0.5 episodes/year (HR 1.25) and highest with >1 episode/year…
