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Diabetic retinopathy is the commonest microvascular complication of diabetes and is still a leading cause of blindness in both the developed and developing world. Previous trials have suggested that intensive glycaemic control and tight blood pressure policies protect against the development of retinopathy. These data have been replicated in a number of trials. The role of lipids in the genesis of retinopathy is much less clear. Lowering lipids certainly reduces cardiovascular events, but outcomes on microvascular disease have been less certain. The fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study showed a beneficial effect of fenofibrate on the progression of diabetic retinopathy.
The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was a three-way factorial randomised study of patients with type 2 diabetes (median duration of diabetes 10 years) of high risk of cardiovascular disease. Patients were randomised to receive either intensive or standard treatment for glycaemia, for systolic blood …
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