GLYCEMIC CONTROL AS A MEASURE TO PREVENT THE DEVELOPMENT OF DIABETIC RETINOPATHY IN PATIENTS WITH DIABETES MELLITUS: A LITERATURE REVIEW

Abstract

Diabetic retinopathy (DR) is one of the most common and severe microvascular complications of diabetes mellitus (DM) and the leading cause of preventable blindness among adults. This study aimed to analyze the impact of intensive glycemic control on the incidence and progression of DR through an integrative literature review. Searches were conducted in PubMed, Scopus, Cochrane Library, and BMC databases, including clinical trials, cohort studies, and meta-analyses published between 1990 and 2025. Fifteen studies met the inclusion criteria. The results revealed that sustained reductions in glycated hemoglobin (HbA1c) are significantly associated with lower risk of developing and worsening DR. The DCCT and UKPDS 35 studies reported reductions of up to 76 % and 37 % in microvascular complications, respectively. Besides hyperglycemia, hypertension, dyslipidemia, and diabetes duration also influence DR progression. It is concluded that intensive glycemic control remains the most effective strategy to prevent and slow the progression of diabetic retinopathy, although an integrated and multifactorial management approach—including metabolic control, ophthalmologic monitoring, and patient education—is essential.