Could Postprandial Hyperglycemia Forecast Diabetic Retinopathy?

Postprandial hyperglycemia may be a predictor of diabetic retinopathy, independent of glycated hemoglobin A1c (HbA1c), according to a retrospective cohort study. The authors collected intrapersonal mean blood glucose levels one to two hours post-breakfast (1–2h-PBBG), post-lunch (1–2h-PLBG), and both (1–2h-PBLBG) over a two-year period from the initial visit. Data were available for 487 patients with 1–2h-PBLBG measurements, 323 with 1–2h-PBBG measurements, and 406 with 1–2h-PLBG measurements. All three groups were followed from 1999 through 2017. Diabetic retinopathy presented in 145 1–2h-PBLBG patients, 92 1–2h-PBBG patients, and 126 1–2h-PBLG patients. Upon multivariate Cox regression analysis, mean 1–2h‐PBLBG, 1–2h‐PBBG, and 1–2h‐PLBG levels predicated diabetic retinopathy, regardless of mean HbA1c. Mean 1–2h‐PBLBG, 1–2h‐PBBG, and 1–2h‐PLBG levels were most significantly predictive of diabetic retinopathy in patients with well-controlled HbA1c (mean <7.0%) and younger age (<60 years).