ArticleActa diabetologica2017
Retinal neurodegeneration in patients with type 1 diabetes mellitus: the role of glycemic variability.
Article in Acta diabetologica, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 1 of them a synthesis that pooled it.
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55 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 citations in OpenAlex.
- The proteasome as a druggable target with multiple therapeutic potentialities: Cutting and non-cutting edges.Pharmacology & therapeutics · 2020Pooled it
- Comparison of glucose fluctuation between metformin combined with acarbose or sitagliptin in Chinese patients with type 2 diabetes: A multicenter, randomized, active-controlled, open-label, parallel design clinical trial.Chinese medical journal · 2025Trial
- Higher Derived Time in Range With IDegLira Versus Insulin Glargine U100 in People With Type 2 Diabetes.Journal of diabetes science and technology · 2024Trial
- Effects of a low-carbohydrate diet in adults with type 1 diabetes management: A single arm non-randomised clinical trial.PloS one · 2023Trial
- Longitudinal effect of glycaemic variability on retinal neurodegeneration and neuropathic characteristics in paediatric patients with type 1 diabetes mellitus.Scientific reports · 2026Article
- Can continuous glucose monitoring-derived glycemic variability predict retinal neurodegeneration earlier than HbA1c in patients without clinically apparent retinopathy?Frontiers in endocrinology · 2026Review
- Post-hypoglycemic nocturnal hyperglycemia in type 1 diabetes: the Somogyi hypothesis revisited.Hormones (Athens, Greece) · 2025Article
- The impact of insulin pump therapy compared to multiple daily injections on complications and mortality in type 1 diabetes: A real-world retrospective cohort study.Diabetes, obesity & metabolism · 2025Article
- The clinical importance of measuring glycaemic variability: Utilising new metrics to optimise glycaemic control.Diabetes, obesity & metabolism · 2024Review
- Gliotic Response and Reprogramming Potential of Human Müller Cell Line MIO-M1 Exposed to High Glucose and Glucose Fluctuations.International journal of molecular sciences · 2024Article
- Structural and functional characterization of retinal impairment in T1DM patients without diabetic retinopathy: a 3-year longitudinal study.Acta diabetologica · 2024Observational
- Clinical relevance of short-term glycemic variability in children and adolescents with type 1 diabetes: a narrative review.Translational pediatrics · 2024Review
- Short-term Glycemic Variability and Its Association With Macrovascular and Microvascular Complications in Patients With Diabetes.Journal of diabetes science and technology · 2024Review
- Retinal age gap as a predictive biomarker for future risk of clinically significant diabetic retinopathy.Acta diabetologica · 2024Article
- To What Extent Is HbJournal of clinical medicine · 2024Article
- Dyslipidemia and reduced retinal layer thicknesses in mild to moderate non-proliferative diabetic retinopathy.American journal of translational research · 2024Article
- Changes in Inner Retina Thickness and Macular Sensitivity in Patients with Type 2 Diabetes with Moderate Diabetic Retinopathy.Biomedicines · 2023Article
- Comprehensive retinal vascular measurements: time in range is associated with peripheral retinal venular calibers in type 2 diabetes in China.Acta diabetologica · 2023Article
- Soluble CD163 and glycated haemoglobin were independently associated with the progression of diabetic retinopathy in adult patients with type 1 diabetes.BMJ open ophthalmology · 2023Article
- Immune Fingerprint in Diabetes: Ocular Surface and Retinal Inflammation.International journal of molecular sciences · 2023Review
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsRecent studies have identified neuroretinal abnormalities in persons affected by diabetes mellitus, before the onset of microvascular alterations. However, the role of glycemic variability (GV) on early retinal neurodegeneration is still not clarified.
methodsTo explore the relationship between glycemic control and neuroretinal characteristics, 37 persons with Type 1 diabetes mellitus (Type 1 DM) divided into two groups with no signs (noRD) and with mild non-proliferative diabetic retinopathy (NPDR) compared to 13 healthy control participants (C) were recruited. All persons underwent an optical coherence tomography with automatic segmentation of all neuroretinal layers. Measurements of mean of nasal (N)/temporal (T)/superior (S)/inferior (I) macular quadrants for individual layer were also calculated. Metabolic control was evaluated by glycated hemoglobin (HbA1c), and indexes of GV were calculated from continuous glucose monitoring.
resultsThe difference among the three groups in terms of RNFL thickness was significantly dependent on quadrant (F(6;132) = 2.315; p = 0.037). This interaction was due to a specific difference in RNFL-N thickness, where both Type 1 DM groups showed a similar reduction versus C (-3.9 for noDR and -4.9 for NPDR), without any relevant difference between them (-1.0). Inner nuclear layer (INL) was increased in all quadrants in the two Type 1 DM groups compared to C (mean difference = 7.73; 95% CI: 0.32-15.14, p = 0.043; mean difference = 7.74; 95% CI: 0.33-15.15, p = 0.043, respectively). A negative correlation between RNFL-N and low blood glucose index (r = -0.382, p = 0.034) and positive correlation between INL and continuous overall net glycemic action -1, -2, -4 h (r = 0.40, p = 0.025; r = 0.39, p = 0.031; r = 0.41, p = 0.021, respectively) were observed in Type 1 DM patients. The triglycerides were positively and significantly correlated to INL (r = 0.48, p = 0.011), in Type 1 DM subjects. GV and triglycerides resulted both independent predictors of increased INL thickness. No correlation was found with HbA1c.
conclusionsEarly structural damage of neuroretina in persons with Type 1 DM patients is related to glucose fluctuations. GV should be addressed, even in the presence of a good metabolic control.
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