Prevention of retinopathy in type 1 diabetes: a systematic review and meta-analysis
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ORAL PRESENTATION
Open Access
Prevention of retinopathy in type 1 diabetes: a systematic review and meta-analysis Sohaib Virk1,2*, Kim Donaghue1,3, Tien Wong4, Maria Craig1,2,3 From 8th APPES Biennial Scientific Meeting Darwin, Australia. 29 October – 1 November 2014 Diabetic retinopathy (DR) is the most serious ocular complication of type 1 diabetes (T1D) and leading cause of acquired blindness in working aged adults. Although various interventions have been trialled to prevent the development or progression of DR, the evidence to support many of these remains unclear. We systematically reviewed the evidence for primary and secondary interventions, to guide the management of DR in people with T1D. Systematic searches were performed using MEDLINE, EMBASE and CENTRAL databases (from January 1990 to June 2014) to identify randomised controlled trials and controlled cohort studies reporting the incidence or progression of DR following administration of systemic interventions. English-language studies with a minimum follow-up of one year were eligible. Meta-analyses of extracted data were performed to determine pooled relative risk (RR) reduction. Twenty-three studies met the inclusion criteria. Intensive insulin therapy significantly reduced the risk of both incident DR (RR 0.44, 95% CI 0.22-0.86, p=0.02) and progression of DR (RR 0.55, 0.31-0.97, p=0.04) compared with conventional therapy. Continuous subcutaneous insulin infusion (CSII) pumps provided significantly greater protection than multiple daily injection therapy (RR 0.33, 95% CI 0.19-0.57, p
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