These studies are notable for two additional findings. First, there is no threshold below which diabetic retinopathy does not occur when glycosylated haemoglobin is elevated; rather, there is a linear relationship between achieved glycosylated haemoglobin level and the risk for visual complications of diabetes. Secondly, persons receiving intensive control had a significant rate of hypoglycaemic reactions, which might argue against such aggressive control in every situation. The choice of a 'target' glycosylated haemoglobin level is therefore arbitrary, involving consideration of the benefits and costs for each patient and thus for each society.
The findings of the United Kingdom Prospective Diabetes Study (19771999) were similar to those of the Diabetes Control and Complications Trial for persons with type 2 diabetes mellitus (36,37). In addition, it highlighted the independent role of systemic hypertension (or its control) in potentiating the development and worsening the progression of diabetic retinopathy Furthermore, like the Diabetes Control and Complications Tral, it demonstrated the negative effects of elevated cholesterol and serum lipid concentrations on the rsk for retinal complications in patients with diabetes mellitus.
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