{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T03:26:14Z","timestamp":1776309974812,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>About 20% of people with diabetes worldwide have diabetic retinopathy (DR); nearly 25% will have DR in 2045.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>DR and vision impairment are associated with atherosclerotic cardiovascular disease (ASCVD), dementia, and mortality.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>DR tracks with hyperglycemia, and intensive glycemic treatment improves DR, although its ultimate effect in reducing visual impairment is less clear.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>But rapid falls from high to more normal HbA1c are associated with worsening DR.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>BP treatment to systolic levels in the low to mid 140\u2009mmHg range is associated with a reduction in DR, but there is some evidence that systolic levels in the low to mid 120\u2009mmHg range are associated with vision loss.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>A number of classes of medications used for ASCVD improve DR, including inhibitors of the Renin\u2010Angiotensin\u2010Aldosterone System (RASi), fenofibrate, and the sodium\u2010glucose transport (SGLT)\u20102 inhibitors.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>It is uncertain whether the glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RA) are associated with improvement or worsening in DR. This may be particularly true with the more potent agents in this class, perhaps so in the context of rapid and large reductions in HbA1c.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:p>","DOI":"10.1111\/1753-0407.70185","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T03:46:12Z","timestamp":1766461572000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diabetes and the Retina: The Role of Medical Treatment"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3863-9267","authenticated-orcid":false,"given":"Zachary","family":"Bloomgarden","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Endocrinology, Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai  New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2021.04.027"},{"issue":"45","key":"e_1_2_11_3_1","first-page":"1069","article-title":"Prevalence of Visual Impairment and Selected Eye Diseases Among Persons Aged >\/=50\u2009Years With and Without Diabetes\u2014United States, 2002","volume":"53","author":"Centers for Disease Control and Prevention (CDC)","year":"2004","journal-title":"MMWR. 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