Diabetes Drugs and Retinopathy: So Far, It's All About Lowering A1C Level

Recent study results have shown that the SGLT2 inhibitors seem to have protective effects against cardiovascular disease and particularly against heart failure, above and beyond their effects on blood glucose levels.

But so far, no class of diabetes drugs stands out as having a protective effect against the retinopathy associated with diabetes, according to Robert Gabbay, M.D., Ph.D., FACP, chief scientific and medical officer for the American Diabetes Association.

Related: Diabetes Can Lead to Leaky Retinal Blood Vessels, Sudden Blindness​

Some early data suggest that there might be some difference among the different classes of diabetes, but “we really don’t know for sure,” Gabbay said in a video interview with Managed Healthcare Executive® this week.

“What we do know, though, is that, in essence, any medication that is going to help lower A1C and get better glucose control lowers the risk of retinopathy,” he said.

Still, Gabbay noted there is some evidence of the SGLT2 inhibitors having some protective effect against kidney disease and that “in some ways, the pathophysiology of renal disease is somewhat analogous to eye disease.”

“They are both diseases of leaky blood vessels,” he noted.

Gabbay added there was old dictum that patients with diabetes who had advanced kidney disease almost certainly had some retinopathy and if they didn’t then the kidney disease was unrelated to their diabetes.