{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:09:38Z","timestamp":1788844178000,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["108\u20102320\u2010B\u2010037\u2010031"],"award-info":[{"award-number":["108\u20102320\u2010B\u2010037\u2010031"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["113\u20102320\u2010B\u2010037\u2010014\u2010MY2"],"award-info":[{"award-number":["113\u20102320\u2010B\u2010037\u2010014\u2010MY2"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011645","name":"Kaohsiung Medical University Chung-Ho Memorial Hospital","doi-asserted-by":"publisher","award":["KMUH 113\u20103R71"],"award-info":[{"award-number":["KMUH 113\u20103R71"]}],"id":[{"id":"10.13039\/501100011645","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Kaohsiung J of Med Scie"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Effective glycemic control and food consumption play crucial roles in modulating diabetic retinopathy (DR) progression. This observational longitudinal study explored the hemoglobin A1c (HbA1c) and dietary patterns and their associations with the risk and progression of DR among 369 individuals with type 2 diabetes. Participants were grouped by DR development as DM (no DR,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009280), DR\u2010M (stable DR,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200940), and DR\u2010W (worsening DR,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200949) over 3\u2009years using the American Academy of Ophthalmology DR Severity Scale. Dietary intake was evaluated using a validated food frequency questionnaire and principal component analysis. High intake was defined as a component score \u2265\u20092\/3 and low as &lt;\u20092\/3. Over 3\u2009years, HbA1c \u2265\u20097% and a diabetes duration &gt;\u200920\u2009years linked to a higher risk of DR\u2010M, with stronger effects seen with high animal protein intake. High animal protein intake was independently correlated with DR\u2010W (OR\u2009=\u20092.58, 95% CI: 1.17\u20135.70). A one\u2010unit increase in HbA1c and HbA1c \u2265\u20097% resulted in 2.33\u2010fold (95% CI: 1.08\u20135.06) and 8.25\u2010fold (95% CI: 1.64\u201341.43) higher risks of DR\u2010W, respectively, in those with high, but not low intake. Poor glycemic control and diabetes duration exceeding 20\u2009years served as key contributors to DR\u2010M development and persistence over 3\u2009years, with higher risks in strata of high animal protein intake. High animal protein intake also intensified the adverse impact of poor glycemic control on DR\u2010W. In summary, moderating animal protein consumption, alongside optimal glycemic management, may be relevant to DR progression. Given small DR subgroup sizes, these exploratory findings require confirmation in larger, independent cohorts.\n                  <\/jats:p>","DOI":"10.1002\/kjm2.70200","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:55:51Z","timestamp":1775735751000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Glycemic Control, Animal Protein Intake, and the Risk of Diabetic Retinopathy Progression Among Patients With Type 2 Diabetes"],"prefix":"10.1002","volume":"42","author":[{"given":"Yu\u2010Ju","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics Kaohsiung Medical University Hospital  Kaohsiung Taiwan"},{"name":"Graduate Institute of Medicine and Department of Public Health and Environmental Medicine, College of Medicine, School of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Cheng","family":"Hsu","sequence":"additional","affiliation":[{"name":"Institute of Population Health Sciences National Health Research Institutes  Miaoli County Taiwan"},{"name":"Department of Health Services Administration China Medical University  Taichung Taiwan"},{"name":"Department of Family Medicine Min\u2010Sheng General Hospital  Taoyuan Taiwan"},{"name":"National Center for Geriatrics and Welfare Research National Health Research Institutes  Yunlin Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Yiu","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang\u2010Jyh","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun\u2010Der","family":"Lin","sequence":"additional","affiliation":[{"name":"The Lin's Clinics  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pi\u2010Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010Fang","family":"Huang","sequence":"additional","affiliation":[{"name":"Institute of Population Health Sciences National Health Research Institutes  Miaoli County Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiao\u2010I","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Public Health and Environmental Medicine, College of Medicine, School of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2188-2121","authenticated-orcid":false,"given":"Meng\u2010Chuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Kaohsiung Medical University Hospital  Kaohsiung Taiwan"},{"name":"Graduate Institute of Medicine and Department of Public Health and Environmental Medicine, College of Medicine, School of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Department of Public Health and Environmental Medicine, College of Medicine, School of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1909"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/0301-4738.100542"},{"issue":"2","key":"e_1_2_9_4_1","first-page":"101","article-title":"Healthcare Utilization by Patients With Diabetes and Diabetic Retinopathy Among National Health Insurance Enrollees in Taiwan","volume":"27","author":"Ming\u2010Tsu Tsai L.\u2010C. 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