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<article xlink="http://www.w3.org/1999/xlink" dtd-version="1.0" article-type="ophthalmology" lang="en">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher">JOHS</journal-id>
      <journal-id journal-id-type="nlm-ta">Journ of Health Scien</journal-id>
      <journal-title-group>
        <journal-title>Journal of HealthCare Sciences</journal-title>
        <abbrev-journal-title abbrev-type="pubmed">Journ of Health Scien</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">2231-2196</issn>
      <issn pub-type="opub">0975-5241</issn>
      <publisher>
        <publisher-name>Radiance Research Academy</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">399</article-id>
      <article-id pub-id-type="doi">http://dx.doi.org/10.52533/JOHS.2025.50501</article-id>
      <article-id pub-id-type="doi-url"/>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Ophthalmology</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Impact of Glycemic Control on Diabetic Retinopathy: A Systematic Review and Meta-analysis&#13;
</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Faraj</surname>
            <given-names>Shahad</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alotaibi</surname>
            <given-names>Afnab D.</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alqahtani</surname>
            <given-names>Abdullah Khaled</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alrasheed</surname>
            <given-names>Abdulelah Ibrahim</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alsahly</surname>
            <given-names>Abdullaziz Abdullah</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>AlHoshan</surname>
            <given-names>Yazeed Saleh</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alsuwailem</surname>
            <given-names>Yousef Luay</given-names>
          </name>
        </contrib>
      </contrib-group>
      <pub-date pub-type="ppub">
        <day>20</day>
        <month>05</month>
        <year>2025</year>
      </pub-date>
      <volume>5</volume>
      <issue>5</issue>
      <fpage>151</fpage>
      <lpage>166</lpage>
      <permissions>
        <copyright-statement>This article is copyright of Popeye Publishing, 2009</copyright-statement>
        <copyright-year>2009</copyright-year>
        <license license-type="open-access" href="http://creativecommons.org/licenses/by/4.0/">
          <license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.</license-p>
        </license>
      </permissions>
      <abstract>
        <p>Background: Diabetic retinopathy (DR) is a significant contributor to visual impairment in diabetic mellitus (DM). Despite the extensive investigation of the relationship between glycemic control and the onset and progression of DR, a comprehensive evaluation of its impact is still necessary. This study aimed to assess the impact of glycemic control on the development of DR and its progression to advanced stages.&#13;
&#13;
Methods: A comprehensive search was conducted using the PubMed, Cochrane Library, and Google Scholar databases, predominantly focusing on studies published between 2008 and 2024. The included studies have compared the incidence of DR and the progressive stages across various levels of glycemic control. Odds ratios (ORs) for the incidence of DR and progression beyond two or three steps, both with/without the mean changes in HbA1c%, were calculated for DR.&#13;
&#13;
Results: Twenty-two studies met the inclusion criteria. Intensive glycemic control significantly reduced the incidence of DR (OR = 0.50, 95% CI [0.38, 0.67]) and the risk of proliferative DR (OR = 0.37, 95% CI [0.30, 0.45]). Furthermore, intensive glycemic control was associated with a reduced likelihood of ?2 steps (OR = 0.77, 95% CI [0.63, 0.94]) and ?3 steps (OR = 0.59, 95% CI [0.42, 0.82]) progression of DR. The pooled analysis revealed that DR cases had significantly higher HbA1c levels than no-DR (Mean Difference = 0.64, 95% CI [0.52, 0.75]). No significant difference in DR risk between patients with different glycemic interventions, such as insulin therapy versus oral tablets.&#13;
&#13;
Conclusions: This study reaffirms the strong association between elevated HbA1c% and development of DR. Strictly keeping HbA1c at optimal levels is significantly effective in lowering both the occurrence and worsening of DR in individuals with diabetes, especially in reducing the likelihood of proliferative DR and more severe progression as measured by the Early Treatment Diabetic Retinopathy Study (ETDRS) scale.&#13;
</p>
      </abstract>
      <kwd-group>
        <kwd>Diabetic retinopathy</kwd>
        <kwd> HbA1c</kwd>
        <kwd> Glycemic control</kwd>
        <kwd> Diabetic mellitus</kwd>
        <kwd> Visual impairment</kwd>
      </kwd-group>
    </article-meta>
  </front>
</article>