Diabetic Retinopathy: impact of glycemic control on the progression of the disease

Abstract

Diabetic Retinopathy (DR) is a microvascular complication associated with diabetes mellitus, being one of the main causes of preventable blindness in adults. This article analyzes the impact of glycemic control on the progression of DR, addressing pathophysiological mechanisms, clinical evidence and guidelines. DR results from structural changes in the retina caused by chronic hyperglycemia, hypertension and dyslipidemia. Studies, such as the DCCT and UKPDS, show that intensive glycemic control significantly reduces the risk of developing and progressing DR: up to 76% in type 1 diabetes and 25% in type 2. The systematic review highlighted the benefits of technologies such as monitors continuous glucose doses and modern medications, such as SGLT2 inhibitors, in the management of DR. However, challenges include inequalities in access to advanced treatments and low therapeutic adherence. Multidisciplinary strategies, integrating endocrinology, ophthalmology and health education, are crucial for effective management. Public policies that promote equity in access to modern technologies are also fundamental. The study recognizes limitations, such as dependence on secondary data, and suggests future research to explore personalized interventions and reduce inequalities in DR management.