{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:48:20Z","timestamp":1790995700258,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic retinopathy remains a leading cause of preventable blindness worldwide, yet screening and management practices vary widely. Evidence suggests that systemic therapies, including fenofibrate, may slow diabetic retinopathy progression, but their use is inconsistent across clinical settings. This study aimed to establish an evidence\u2010informed consensus among endocrinology experts on the screening, diagnosis, and treatment of diabetic retinopathy, with a particular focus on recommendations for the use of systemic therapy to prevent disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A modified three\u2010round Delphi process was conducted with 19 endocrinology experts from diverse geographic regions. A core panel of 10 experts and an extended panel of 9 reviewed and rated 19 evidence\u2010based statements. Consensus was defined as &gt;\u200975% agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 19 statements achieved consensus, with 14 receiving &gt;\u200980% agreement. The panel endorsed frequent diabetic retinopathy screening based on diabetes type and risk level, early initiation of fenofibrate in patients with mild to moderate non\u2010proliferative diabetic retinopathy, and continued therapy to sustain retinal protection. Fenofibrate was recognized for its pleiotropic effects, and the experts agreed that the transient rise in serum creatinine with fenofibrate is not indicative of renal damage and should not prompt discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This consensus highlights the need for multidisciplinary care, coordinated pathways, and patient education in diabetic retinopathy care. It also offers unified, evidence\u2010informed recommendations for endocrinologists for the early initiation of fenofibrate to reduce diabetic retinopathy progression. While further studies are needed, these findings offer a practical framework for improving diabetic retinopathy management globally.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1753-0407.70193","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T12:19:37Z","timestamp":1770898777000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Delphi Consensus on the Use of Fenofibrate as Systemic Therapy for the Prevention of Diabetic Retinopathy Progression"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-477X","authenticated-orcid":false,"given":"Richard C.","family":"O'Brien","sequence":"first","affiliation":[{"name":"Austin Clinical School, Melbourne Medical School University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalifa","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Unit, Department of Internal Medicine Alexandria University  Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuehong","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Sir Run Run Shaw Hospital of Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Hassanein","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes Dubai Hospital, Dubai Academic Health Cooperation  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3010-5837","authenticated-orcid":false,"given":"Qiuhe","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Xi'an International Medical Center Hospital of Northwest University  Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakir Ozgur","family":"Keskek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine Alanya Alaaddin Keykubat University  Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9122-8742","authenticated-orcid":false,"given":"Patricio","family":"Lopez\u2010Jaramillo","sequence":"additional","affiliation":[{"name":"Masira Research Institute, Medical School, Universidad de Santander  Bucaramanga Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopa","family":"Mehta","sequence":"additional","affiliation":[{"name":"Departamento de Endocrinolog\u00eda y Metabolismo and Unidad de Investigaci\u00f3n en Enfermedades Metab\u00f3licas (UIEM) Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  M\u00e9xico City M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein","family":"Raef","sequence":"additional","affiliation":[{"name":"Department of Executive Health Medicine King Faisal Specialist Hospital and Research Center  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Tan","sequence":"additional","affiliation":[{"name":"Farrer Park Hospital  Singapore 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