Higher HbA1c may reduce axial length elongation in myopic children: a comparison cohort study

A Correction to this article was published on 13 April 2021

This article has been updated



To compare the annual axial length (AL) changes in myopic children with type 1 diabetes mellitus (T1DM) and those without diabetes.


There are two groups of myopic children in this retrospective cohort study. Group 1 consisted of myopic children with T1DM (44 eyes of 22 patients). Group 2 comprised age-matched myopic children without diabetes (44 eyes of 22 children). These two groups were compared with regard to their baseline clinical characteristics. A generalized estimating equations (GEE) model was also used to determine the most likely factor that contributed to the results.


The average ages of group 1 and group 2 were 14.8 and 14.6 years, respectively. Children in group 1 had significantly slower annual AL changes (0.051 mm/year vs 0.103 mm/year; 50.5% slower, P = 0.011) and shorter baseline AL (23.97 vs 25.19 mm, P < 0.001) than those in group 2. GEE also showed that serum glycated hemoglobin (HbA1c) level (B = −0.023, P = 0.039) was the most important factor in reducing AL elongation in group 1 myopic children.


Long-term higher HbA1c level may reduce AL elongation. A strict blood sugar control strategy in clinical practice is warranted to axial myopia progression in T1DM children.

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Fig. 1

Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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The authors thank the Bio-Statistical Consultation Center of Chang Gung Memorial Hospital, Keelung, Taiwan for professional manuscript preparation advice.


Chun-Fu Liu was supported by the research grant CMRPG 2I0131 from Chang Gung Memorial Hospital, Keelung, Taiwan. Eugene Yu-Chuan Kang and Chi-Chun Lai were supported by the research grant CMRPG 3K0481 from Chang Gung Memorial Hospital, Linkou, Taiwan. Nan-Kai Wang was supported by the research grant R01EY031354 from National Eye Institute, United State of America. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information




Chun-Fu Liu, Shin-Chieh Chen, Fu-Sung Lo and Nan-Kai Wang contributed to the study conception and design. All authors performed material preparation and data collection. Chun-Fu Liu and Shin-Chieh Chen performed data analysis, interpretation and wrote the first draft of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Fu-Sung Lo or Nan-Kai Wang.

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This study was reviewed and approved by the institutional review board of Chang Gung Memorial Hospital. Approval Number: 202001771B0.

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No informed consent was obtained as this study analyzed de-identified participant data for which formal consent is not required. The study protocol and a waiver for consent to participation were approved by the Institutional Review Board of Chang Gung Memorial Hospital (Approval No.: 202001771B0) and followed the tenets of the Declaration of Helsinki.

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This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques.

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Liu, CF., Chen, SC., Chen, KJ. et al. Higher HbA1c may reduce axial length elongation in myopic children: a comparison cohort study. Acta Diabetol (2021). https://doi.org/10.1007/s00592-020-01631-4

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  • Axial length
  • Children
  • HbA1c
  • Myopia
  • Type 1 diabetes mellitus