skip to main content

Diabetic retinopathy — SCE Endocrinology MCQ

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

ModerateDiabetes complicationsDiabetic retinopathySCE Endocrinology

A 44-year-old man with type 1 diabetes has proliferative retinopathy treated with laser. HbA1c has fallen from 92 to 57 mmol/mol in 3 months after starting continuous glucose monitoring. He asks about further intensification. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: C — Arrange urgent ophthalmology review and continue careful glycaemic optimisation

Arrange urgent ophthalmology review and continue careful glycaemic optimisation is best because rapid glycaemic improvement can transiently worsen established retinopathy, so ophthalmic surveillance should accompany continued optimisation. The alternatives are less appropriate because stopping control sacrifices long-term benefit; aspirin and pioglitazone do not treat proliferative disease; delayed review is unsafe after a rapid HbA1c fall. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: NICE NG17; diabetic eye screening guidance