The Effect of Interventions to Prevent Type 2 Diabetes on the Development of Diabetic Retinopathy: The DPP/DPPOS Experience

Authors

Neil H White
Qing Pan
William C Knowler
Emily B Schroeder
Dana Dabelea
Emily Y Chew
Barbara Blodi
Ronald B Goldberg
Xavier Pi-Sunyer
Christine Darwin
Mathias Schlögl
David M Nathan

Language

English

Publication Date

7-1-2022

Journal

Diabetes Care

DOI

10.2337/dc21-2417

PMID

40315174

PMCID

PMC9375445

PubMedCentral® Posted Date

5-25-2022

PubMedCentral® Full Text Version

Author MSS

Abstract

Objective: To determine whether interventions that slow or prevent the development of type 2 diabetes in those at risk reduce the subsequent prevalence of diabetic retinopathy.

Research design and methods: The Diabetes Prevention Program (DPP) randomized subjects at risk for developing type 2 diabetes because of overweight/obesity and dysglycemia to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB) to assess the prevention of diabetes. During the DPP and DPP Outcome Study (DPPOS), we performed fundus photography over time on study participants, regardless of their diabetes status. Fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study grading system, with diabetic retinopathy defined as typical lesions of diabetic retinopathy (microaneurysms, exudates, or hemorrhage, or worse) in either eye.

Results: Despite reduced progression to diabetes in the ILS and MET groups compared with PLB, there was no difference in the prevalence of diabetic retinopathy between treatment groups after 1, 5, 11, or 16 years of follow-up. No treatment group differences in retinopathy were found within prespecified subgroups (baseline age, sex, race/ethnicity, baseline BMI). In addition, there was no difference in the prevalence of diabetic retinopathy between those exposed to metformin and those not exposed to metformin, regardless of treatment group assignment.

Conclusion: Interventions that delay or prevent the onset of type 2 diabetes in overweight/obese subjects with dysglycemia who are at risk for diabetes do not reduce the development of diabetic retinopathy for up to 20 years.

Published Open-Access

yes

Recommended Citation

White, Neil H; Pan, Qing; Knowler, William C; et al., "The Effect of Interventions to Prevent Type 2 Diabetes on the Development of Diabetic Retinopathy: The DPP/DPPOS Experience" (2022). Children’s Nutrition Research Center Staff Publications. 206.
https://digitalcommons.library.tmc.edu/staff_pub/206