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Diabetic retinopathy — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateDiabetesDiabetic retinopathySCE Endocrinology

A 59-year-old woman with type 2 diabetes develops sudden blurring of vision 3 months after HbA1c falls from 98 to 50 mmol/mol on intensive therapy. Fundoscopy shows worsening proliferative retinopathy. What is the most likely explanation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Early worsening of retinopathy after rapid glycaemic improvement

Rapid improvement in chronic hyperglycaemia can transiently worsen diabetic retinopathy, especially where baseline retinopathy is advanced. Metformin and SGLT2 inhibitors do not typically cause this retinal pattern. Retinal assessment should be part of intensification planning in high-risk patients.

Reference: NICE NG28; NICE Diabetic Retinopathy Guidance