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A retrospective, case-control, cross-sectional design evaluated systemic factors using univariate and multivariate logistic regression and assessed glycemic control as a predictor via ROC curves. Findings show glycemic exposure alone is insufficient and highlight kidney-related and demographic and treatment associations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/role-of-systemic-factors-in-the-progression-to-vision-threatening-diabetic-retinopathy-in-a-new-mexican-patient-population-with-type-2-diabetes-research-article/453711/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/role-of-systemic-factors-in-the-progression-to-vision-threatening-diabetic-retinopathy-in-a-new-mexican-patient-population-with-type-2-diabetes-research-article/453711.png","ImageObject",300,407,{"name":92,"@type":93},"Genevieve","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What vision-threatening DR outcomes were assessed in this study?","Question",{"text":112,"@type":113},"The study assessed proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) as vision-threatening complications.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the relationship between systemic factors and DR outcomes analyzed?",{"text":117,"@type":113},"Systemic factors were tested with univariate and multivariate logistic regression, and ROC curve analysis was used to evaluate how well glycemic control predicts DR end-complications.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the study conclude about HbA1c as a predictor of DR progression?",{"text":121,"@type":113},"Glycemic exposure alone was not a good enough predictor of DR progression; HbA1c did not show a significant association with PDR but was associated with NPDR with DME.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},453711,1791040131,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},1374391974585,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Wiley  \nJournal of Diabetes Research  \nVolume 2026, Article ID 7203748, 8 pages [https://doi.org/10.1155/jdr/7203748](https://doi.org/10.1155/jdr/7203748)  \nResearch Article  \nRole of Systemic Factors in the Progression to Vision-Threatening Diabetic Retinopathy in a New Mexican Patient Population with Type 2 Diabetes: Glycemic Control Is Not Enough  \nRushi N. Mankad , 1 Lauren Marek , 1 Gabriella Acosta , 1 Andrea P. Cabrera , 1 Finny Monickaraj , 1,2 Clifford Qualls , 1,2 and Arup Das 1,2  \n1Department of Ophthalmology & Visual Sciences, The University of New Mexico School of Medicine, Albuquerque, New Mexico, USA  \n2New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico, USA  \nCorrespondence should be addressed to Arup Das; [adas@unm.edu](adas@unm.edu)  \nReceived 25 April 2025; Revised 24 October 2025; Accepted 22 November 2025  \nAcademic Editor: Riccardo Calafiore  \nCopyright © 2026 Rushi N. Mankad et al. Journal of Diabetes Research published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \nPurpose: The purpose of this study is to identify associative factors of vision threatening complications of diabetic retinopathy (DR), including proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) in a New Mexican patient population with Type 2 diabetes featuring a high proportion of Hispanic and American Indian patients.  \nMethods: In a retrospective, case-control, cross-sectional study, we performed both univariate and multivariate logistic regression testing of systemic factors for association among patients with nonproliferative diabetic retinopathy (NPDR) without DME, NPDR with DME, and PDR. We also used receiver operating characteristic (ROC) curves to understand how reliable glycemic control is at predicting DR end-complications.  \nResults: Among our 584 patients, 172 were diagnosed with NPDR without DME, 293 with PDR, and 119 with NPDR with DME. A total of 25% of patients with NPDR without DME had poor glycemic control (HbA1c levels of ≥ 9.0%) . Similarly, 10% of PDRand 7% of NPDR with DME patients had good glycemic control (HbA1c levels ≤ 7.0%), despite their advanced eye disease. For patients with PDR, we identified significant independent associations with microalbuminuria and macroalbuminuria, Hispanic ethnicity, duration of diabetes, and the use of insulin and beta-blocker medications. In NPDR with DME patients, significant associations were noted with microalbuminuria and macroalbuminuria, HbA1c, GFR, and beta-blocker medications. The hemoglobin A1c level was not significantly associated with PDR but was significantly associated with NPDR with DME. The ROC curve analysis indicated poor predictability for the HbA1c model concerning the presence of PDR (AUC = 0  640) and NPDR with DME (AUC = 0  640) .  \nConclusions: This study suggests that glycemic exposure alone is not a good enough predictor of DR progression. Other diabetic microvascular complications such as nephropathy, in addition to race/ethnicity with differing genetic associative factors, may also play a role in the multifactorial progression through DR phenotypes.  \nKeywords: diabetes mellitus; diabetic macular edema (DME); diabetic retinopathy (DR); glycated hemoglobin (HbA1c);  \nproliferative diabetic retinopathy (PDR)  \n1. Introduction  \nMany landmark clinical trials, such as the DCCT (Diabetes Control and Complications Trial), UKPDS (United Kingdom Prospective Diabetes Study), and ACCORD (Action  \nto Control Cardiovascular Risk in Diabetes) Eye Study, have established the importance of strict blood glucose control in preventing or delaying the complications of diabetes mellitus, including diabetic retinopathy (DR) [1–3] . The severity of glycemia, as well as the duration of diabetes, hypertension,  \n2 Journal of Diabetes Research  \nand hyperlipidemia","cbCaipMQUZJ9iJLo","https://ap.wps.com/l/cbCaipMQUZJ9iJLo","pdf",1125644,"English","# Purpose\n# Methods\n## Subjects\n# Results\n# Conclusions","[{\"question\":\"What vision-threatening DR outcomes were assessed in this study?\",\"answer\":\"The study assessed proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) as vision-threatening complications.\"},{\"question\":\"How was the relationship between systemic factors and DR outcomes analyzed?\",\"answer\":\"Systemic factors were tested with univariate and multivariate logistic regression, and ROC curve analysis was used to evaluate how well glycemic control predicts DR end-complications.\"},{\"question\":\"What did the study conclude about HbA1c as a predictor of DR progression?\",\"answer\":\"Glycemic exposure alone was not a good enough predictor of DR progression; HbA1c did not show a significant association with PDR but was associated with NPDR with DME.\"}]","Role of Systemic Factors in the Progression to Vision-Threatening Diabetic Retinopathy in a New Mexican Patient Population with Type 2 Diabetes - Research Article | PDF",1790739420]