Effects of glycaemic control modalities on the risk of retinal microaneurysms in diabetes patients: an analysis based on NHANES data

Clin Exp Optom. 2026 Apr 13:1-11. doi: 10.1080/08164622.2026.2652027. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: Diabetic retinopathy is a leading cause of blindness among working-age adults. Regular fundus examinations by optometrists enable its early detection and intervention, thus preventing vision loss.

BACKGROUND: Patients with diabetes are particularly susceptible to microvascular complications, with retinal microaneurysms (RMAs) serve as an early indicator of these diabetic retinal microvascular complications. Although glycaemic control is the principal strategy for preventing diabetic complications, the specific effects of various blood glucose control methods on the development of RMA remain unclear.

METHODS: On the basis of the 2005-2008 National Health and Nutrition Examination Survey (NHANES) data, the baseline data of 5,398 participants were analysed using a Pearson correlation coefficient matrix. Univariate logistic regression was employed to examine the differences in demographic characteristics, behavioural factors, and other lifestyle variables. Variables that demonstrated statistical significance in the univariate analysis, as well as those identified as clinically relevant on the basis of practical experience, were included inmultivariate regression analysis.

RESULTS: Insulin monotherapy significantly increased RMA risk, with an odds ratio (OR) of 7.449 (p < 0.001). In contrast, the use of diabetic pills alone did not have a significantly affect on RMA risk (OR = 1.597, p = 0.135). Furthermore, combination therapy, which included both insulin and diabetic pills, led to a 72% reduction in RMA risk (OR = 0.281, p < 0.01). In patients with diabetes, sex and fasting glucose levels were identified as independent risk factors for RMA.

CONCLUSION: There is a synergistic protective effect of combination therapy on diabetic RMA, providing valuable evidence for blood glucose control in insulin-dependent patients.

PMID:41974170 | DOI:10.1080/08164622.2026.2652027