The objective of this study was to assess the long-term role of intensive glycemic control (INT) compared with standard glycemic control in accumulated eye procedures in patients with advanced diabetes.

We compared the effect of treatment assignment on the accumulated number of eye procedures during the intervention period of the Veteran Affairs Diabetes Trial (VADT) (2000–2008) (median follow-up 5.6 years), the interim VADT follow-up study (2000–2013), and the full 17 years of VADT follow-up (2000–2017). We further analyzed data using various cardiovascular markers in two models. Model I included total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, systolic and diastolic blood pressure, and BMI. Model II included these covariates plus age and diabetic retinopathy (DR) severity score at baseline of the original trial.

The final analysis of the data showed a mild but nonsignificant increase in number of procedures and in retinal or retinal plus cataract surgery during the three periods of the study.

We found no significant benefit of INT during the original trial period in eye-related procedures, such as various procedures for DR, or during the 17 years of follow-up in cataract surgery. However, after adjusting data for some known vascular markers, the increase in the number of eye procedures with INT becomes more prevalent. This finding indicates that INT might not have a protective role in events requiring surgery in individuals with advanced diabetes.

本研究的目的是评估强化血糖控制 (INT) 与标准血糖控制在晚期糖尿病患者累积眼科手术中的长期作用。

我们比较了在退伍军人事务糖尿病试验 (VADT) (2000-2008)（中位随访 5.6 年）、中期 VADT 随访研究 (2000) 干预期间治疗分配对累计眼科手术次数的影响–2013 年），以及 17 年的 VADT 随访（2000–2017 年）。我们在两个模型中使用各种心血管标志物进一步分析了数据。模型 I 包括总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、收缩压和舒张压以及 BMI。模型 II 包括这些协变量加上原始试验基线的年龄和糖尿病视网膜病变 (DR) 严重程度评分。

数据的最终分析显示，在研究的三个时期内，手术次数和视网膜或视网膜加白内障手术的数量略有增加，但并不显着。

在最初的试验期间，我们发现 INT 在眼相关手术（例如 DR 的各种手术）或白内障手​​术的 17 年随访期间没有显着益处。然而，在调整了一些已知血管标志物的数据后，INT 眼科手术数量的增加变得更加普遍。这一发现表明 INT 在晚期糖尿病患者需要手术的事件中可能没有保护作用。