Treatment of an eye by ultrasound

Personalising the eye care treatment given to diabetes patients does not improve HbA1c levels, according to new research.

The study, conducted by the Diabetic Retinopathy Clinical Research Network, found that there were no benefits to glycemic control for retinopathy patients who were given personalised eye care.

That said, the authors insisted that personalised care and education remained vital to developing more effective treatments for diabetes and its complications; just not the kind carried out in the study.

The researchers recruited 42 ophthalmologists, who were then split into two groups. One group provided standard care for people with diabetes during eye checks, and the other provided “augmented” care.

Augmented care involved measurements of HbA1c, blood pressure, and the extent of retinopathy, as well as personalised estimates of how likely the patient was to develop a more severe form of retinopathy. Patients receiving augmented care also had reviews of previous findings, and feedback-based structured education.

Every patient participating in the study had an HbA1c level of 6.0 per cent or more. On average, the participants had between 8.3 and 8.6 per cent HbA1c. Patients with both type 1 and type 2 diabetes were recruited.

After a year, the participants who received augmented care showed no real improvement in HbA1c levels. Neither did they see any secondary benefits, such as lower blood pressure, emotional improvements, or changes to BMI.

“Although the addition of personalised education and risk assessment during opthalmologic visits in our study did not improve glycemic control, long-term optimisation of glycemic control is still a cornerstone of diabetes care,” said the researchers.

“These results suggest that optimising glycemic control requires more extensive interventional paradigms than were examined in our study and further research into new technologies and models of behavioural change.

“In the meantime, ophthalmologists and all other diabetes care professionals should continue their efforts to maximise education, assessment, systemic control and treatment of complications for patients with diabetes.”