Retinal haemodynamics in individuals with well-controlled type 1 diabetes

• Published in: Diabetologia Vol. 51; no. 2; pp. 361 - 364
• Main Authors: Lorenzi, M, Feke, G. T, Cagliero, E, Pitler, L, Schaumberg, D. A, Berisha, F, Nathan, D. M, McMeel, J. W
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Berlin/Heidelberg : Springer-Verlag 01-02-2008; Springer-Verlag; Springer; Springer Nature B.V
• Subjects: Adult; Biological and medical sciences; Confounding (Statistics); Diabetes; Diabetes Mellitus, Type 1 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic retinopathy; Diabetic Retinopathy - physiopathology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Eye and associated structures. Visual pathways and centers. Vision; Female; Fundamental and applied biological sciences. Psychology; Glucose; Hemodynamics; Hemodynamics - physiology; Hospitals; Human Physiology; Humans; Hyperglycemia; insulin-dependent diabetes mellitus; Internal Medicine; Laser-Doppler Flowmetry; Lasers; Male; Medical schools; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Ophthalmology; Preventive medicine; Retina - physiopathology; Retinal blood flow; Retinal circulation; Retinal Vessels - physiopathology; Retinopathies; Short Communication; Veins & arteries; Vertebrates: nervous system and sense organs; Young Adult; United States > US; Massachusetts; Diabetic retinopathy; Retinal blood flow; Retinal circulation; Type 1 diabetes; Endocrinopathy; Human; Immunopathology; Retinopathy; Controlled diabetes; Autoimmune disease; Retina; Diabetic retinopathy, Retinal blood flow; Blood flow; Eye; Visual system; Eye disease; Hemodynamics
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-007-0872-0

Aims/hypothesis Abnormalities in retinal haemodynamics have been reported in patients with type 1 diabetes in advance of clinical retinopathy. These abnormalities could therefore be useful as early markers or surrogate endpoints for studying the microangiopathy. Since the DCCT, the increased focus on good glycaemic control is changing the natural history of diabetic retinopathy. Based on this, the aim of this study was to investigate whether patients with type 1 diabetes treated entirely or mostly in the post-DCCT era and tested in the absence of confounding factors show retinal haemodynamic abnormalities. Methods We measured retinal haemodynamics by laser Doppler flowmetry in 33 type 1 diabetic individuals with no or minimal retinopathy (age 30 ± 7 years, duration of diabetes 8.8 ± 4.6 years, 9% showing microaneurysms), and 31 age- and sex-matched non-diabetic controls. The study participants were not taking vasoactive medications, and blood glucose at the time of haemodynamic measurements was required to be between 3.8 and 11.1 mmol/l. Results HbA₁c was 7.5 ± 1.2% and blood glucose 7.7 ± 2.8 mmol/l in these type 1 diabetic individuals, indicating relatively good glycaemic control. Retinal blood speed, arterial diameter and blood flow were not different between the diabetic individuals and the matched controls. Conclusions/interpretation Type 1 diabetic patients with no or minimal retinopathy who maintain relatively good glycaemic control do not show abnormalities of the retinal circulation at steady state, even after several years of diabetes. In such patients it may be necessary to test the vascular response to challenges to uncover any subtle abnormalities of the retinal vessels.