Glycemic variability may signal retinal changes

Greater glucose fluctuations but not HbA1c were associated with neuroretinal alterations over 3 years in pediatric patients with type 1 diabetes.

By
Andrea Surnit
September 1, 2026
3 min

MDSpire News

Overview

A longitudinal study found that glycemic variability is associated with early neuroretinal changes in pediatric patients with type 1 diabetes. Specifically, greater glycemic variability correlated with thinner retinal layers, while greater time in range was linked to thicker layers.

Background

Understanding the relationship between glycemic variability and retinal changes is crucial for early detection of diabetic complications in pediatric patients with type 1 diabetes.

Data Highlights

Measure	Type 1 Diabetes Patients	Controls
Inner retinal nerve fiber layer thickness	20 μm	21 μm

Key Findings

Inner retinal nerve fiber layer thickness was lower in type 1 diabetes patients compared to controls.
During follow-up, significant thinning was observed in the inner ganglion cell layer and outer plexiform layer among patients.
Greater glycemic variability was associated with thinner inner nuclear and outer plexiform layers.
Greater time in range correlated with thicker retinal layers.
Changes in retinal layers correlated with neuropathy screening scores and blood pressure changes.

Clinical Implications

Clinicians should consider monitoring glycemic variability in pediatric patients with type 1 diabetes as it may provide insights into early neuroretinal changes. This could inform screening strategies and management of potential diabetic complications.

Conclusion

The study suggests that glycemic variability may serve as a marker for early neuroretinal changes in pediatric patients with type 1 diabetes, warranting further investigation into its predictive value for diabetic neuropathy.