American Diabetes Association

TABLE 1

Key Components of Diabetes That Are Related to the Progression of DRD

Component	Considerations
Hyperglycemia	Glycemia has the strongest link to DRD progression. Its degree and duration correlate with DRD. DRD progression is slowed by achieving glycemic targets.
Hypertension	DRD progression is slowed by achieving a systolic blood pressure <130 mmHg. There may be reduced need for intravitreal anti-VEGF injections when blood pressure targets are achieved.
Dyslipidemia	Treatment with statin therapy, when appropriate, may reduce the risk of DME. Treatment of hypertriglyceridemia with fenofibrate, when appropriate, may reduce DRD progression.
Diabetes-related nephropathy	The presence of renal insufficiency may be a risk factor for DRD progression. Initiation of dialysis may improve DME.
Diabetes-related neuropathy	The presence of neuropathy may be a risk factor for DRD progression.
Pregnancy	Pregnancy is associated with transient but rapid worsening of DRD. Increase surveillance to occur in each trimester of pregnancy and for 1 year postpartum based on the degree of DRD.

Component	Considerations
Hyperglycemia	Glycemia has the strongest link to DRD progression. Its degree and duration correlate with DRD. DRD progression is slowed by achieving glycemic targets.
Hypertension	DRD progression is slowed by achieving a systolic blood pressure <130 mmHg. There may be reduced need for intravitreal anti-VEGF injections when blood pressure targets are achieved.
Dyslipidemia	Treatment with statin therapy, when appropriate, may reduce the risk of DME. Treatment of hypertriglyceridemia with fenofibrate, when appropriate, may reduce DRD progression.
Diabetes-related nephropathy	The presence of renal insufficiency may be a risk factor for DRD progression. Initiation of dialysis may improve DME.
Diabetes-related neuropathy	The presence of neuropathy may be a risk factor for DRD progression.
Pregnancy	Pregnancy is associated with transient but rapid worsening of DRD. Increase surveillance to occur in each trimester of pregnancy and for 1 year postpartum based on the degree of DRD.

Adapted from ref. 1.