JAN 15, 2015
This analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study confirms the initial report. Intensive glycemia treatment slows progression of retinopathy in patients whose average age and diabetes duration were 62 and 10 years, respectively, and who had cardiovascular disease or cardiovascular risk factors. Patients with mild retinopathy appeared to benefit most.
Additionally, this is the second study to confirm the benefits of fenofibrate in slowing retinopathy progression, leading the authors to conclude that fenofibrate combined with a statin should be considered for mild and moderate diabetic retinopathy, especially for those who cannot achieve good glycemic control. For patients without evidence of diabetic retinopathy, further studies with a larger sample size or a surrogate measure of progression would help evaluate the role of fenofibrate in primary prevention of diabetic retinopathy.