Diabetic Retinopathy Outcomes and Early Worsening of Diabetic Retinopathy

Diabetic Retinopathy Outcomes and Early Worsening of Diabetic Retinopathy in Adolescents and Young Adults With Type 1 Diabetes Following Rapid and Large Glycemic Improvements After Commencing Automated Insulin Delivery Warunyuwong W, et al. J Diabetes Sci Technol. 2026. https://doi.org/10.1177/19322968261446654 The conversation around early worsening of diabetic retinopathy usually gets attached to GLP-1s right now, but this paper is a good reminder that early worsening of diabetic retinopathy (EWDR) is a glycemic phenomenon, not a drug-specific one. Automated insulin delivery produced a mean HbA1c drop of 2.1 percentage points in this cohort of adolescents and young adults, and 24% of them showed some degree of retinal worsening. That sounds alarming until you read further: only three participants actually required treatment, all three had preexisting retinopathy plus other complications, and the treatment rate sits right at the background progression rate for T1D regardless of…