If you have diabetic retinopathy, what can you do to slow its progression? Of course, tight blood glucose control lessens the risk that retinopathy will get worse. And treating other conditions, such as high blood pressure and abnormal cholesterol levels, may also slow progression. What about Avandia? A reader asks: I’ve heard that the diabetes medication Avandia can slow the progression of diabetic retinopathy. Should everyone with this condition be taking it?
Johns Hopkins answers: Not necessarily. Rosiglitazone (Avandia) is currently prescribed to control high blood sugar in people with type 2 diabetes. Recently, a study in the Archives of Ophthalmology reported that it may also inhibit the growth of new blood vessels in the eye, delaying the onset of a more advanced stage of diabetic retinopathy known as proliferative diabetic retinopathy (PDR).
Researchers reviewed the medical records of 282 people with diabetes. This included 124 people treated with Avandia and 158 who were not. A total of 38 people were at significant risk of progression to PDR. Both groups were followed for an average of three years. Among the high-risk group, those who took Avandia had a 60% lower risk of PDR than those who didn’t take it. Also, fewer people in the Avandia group had a loss of three or more lines on a standard vision chart.
The news isn’t all good, however. The FDA now requires Avandia to carry a label warning that it has been shown to increase the risks of heart attack and heart failure.
The bottom line: It’s premature to recommend taking Avandia to prevent the progression of diabetic retinopathy. There are many other effective oral medications for type 2 diabetes. For now, if your condition is under control while using another medication, there’s no reason to switch -- even if you have diabetic retinopathy.
