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糖尿病性黄斑水肿抗VEGF治疗开始后的血糖控制

Glycemic Control after Initiation of Anti-VEGF Treatment for Diabetic Macular Edema.

作者信息

Oshima Hideyuki, Takamura Yoshihiro, Hirano Takao, Shimura Masahiko, Sugimoto Masahiko, Kida Teruyo, Matsumura Takehiro, Gozawa Makoto, Yamada Yutaka, Morioka Masakazu, Inatani Masaru

机构信息

Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Yoshida 910-1193, Fukui, Japan.

Department of Ophthalmology, Shinshu University School of Medicine, Nagano 390-0802, Matsumoto, Japan.

出版信息

J Clin Med. 2022 Aug 9;11(16):4659. doi: 10.3390/jcm11164659.

Abstract

Diabetic macular edema (DME) induces visual disturbance, and intravitreal injections of anti-vascular endothelial growth factor (VEGF) drugs are the accepted first-line treatment. We investigate its impact on glycemic control after starting VEGF treatment for DME on the basis of a questionnaire and changes in hemoglobin A1c (HbA1c). We conducted a retrospective multicenter study analyzing 112 patients with DME who underwent anti-VEGF therapy and their changes in HbA1c over two years. Central retinal thickness and visual acuity significantly improved at three months and throughout the period after initiating therapy (p < 0.0001); a significant change in HbA1c was not found. A total of 59.8% of patients became more active in glycemic control through exercise and diet therapy after initiating therapy, resulting in a significantly lower HbA1c at 6 (p = 0.0047), 12 (p = 0.0003), and 18 (p = 0.0117) months compared to patients who did not. HbA1c was significantly lower after 18 months in patients who stated that anti-VEGF drugs were expensive (p = 0.0354). The initiation of anti-VEGF therapy for DME affects HbA1c levels in relation to more aggressive glycemic control.

摘要

糖尿病性黄斑水肿(DME)会导致视力障碍,玻璃体内注射抗血管内皮生长因子(VEGF)药物是公认的一线治疗方法。我们基于一份调查问卷以及糖化血红蛋白(HbA1c)的变化情况,研究了开始针对DME进行VEGF治疗后其对血糖控制的影响。我们开展了一项回顾性多中心研究,分析了112例接受抗VEGF治疗的DME患者及其在两年内HbA1c的变化情况。治疗开始后三个月及整个期间,视网膜中央厚度和视力均有显著改善(p < 0.0001);未发现HbA1c有显著变化。共有59.8%的患者在开始治疗后通过运动和饮食疗法在血糖控制方面变得更加积极,与未采取这些措施的患者相比,在6个月(p = 0.0047)、12个月(p = 0.0003)和18个月(p = 0.0117)时HbA1c显著降低。表示抗VEGF药物昂贵的患者在18个月后HbA1c显著更低(p = 0.0354)。开始针对DME进行抗VEGF治疗会通过更积极的血糖控制影响HbA1c水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6b5/9410407/c78bff21c0c3/jcm-11-04659-g001.jpg

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