Progression of Retinopathy in Insulin-Treated Type 2 Diabetic Patients

• Published in: Diabetes care Vol. 25; no. 2; pp. 381 - 385
• Main Authors: HENRICSSON, Marianne, BERNTORP, Kerstin, FERNLUND, Per, SUNDKVIST, Göran
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-02-2002
• Subjects: Aged; Biological and medical sciences; Care and treatment; Case-Control Studies; Clinical Medicine; Development and progression; Diabetes; Diabetes Mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic retinopathy; Diabetic Retinopathy - physiopathology; Disease Progression; Endocrine pancreas. Apud cells (diseases); Endocrinology and Diabetes; Endocrinopathies; Endokrinologi och diabetes; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Follow-Up Studies; Human; Humans; Hypoglycemic Agents - administration & dosage; Insulin; Insulin - administration & dosage; Klinisk medicin; Logistic Models; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Age; Middle Aged; Non-Insulin-Dependent: complications; Non-Insulin-Dependent: drug therapy; Non-Insulin-Dependent: physiopathology; Non-U.S. Gov't; Ophthalmology; Patients; Physiological aspects; Prospective Studies; Retina; Retinopathies; Studies; Support; Treatment Outcome; Type 2 diabetes; Sweden; Endocrinopathy; Human; Eye disease; Retinopathy; Treatment; Case control study; Insulin like growth factor 1; Non insulin dependent diabetes; Insulin
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/diacare.25.2.381

Progression of Retinopathy in Insulin-Treated Type 2 Diabetic Patients
Marianne Henricsson , MD, PHD 1 ,
Kerstin Berntorp , MD, PHD 2 ,
Per Fernlund , MD, PHD 3 and
Göran Sundkvist , MD, PHD 2
1 Department of Ophthalmology, University Hospital, Malmö, Sweden
2 Department of Endocrinology, University Hospital, Malmö, Sweden
3 Department of Clinical Chemistry, University Hospital, Malmö, Sweden
Abstract
OBJECTIVE —To study the progression of retinopathy 3 years after initiation of insulin therapy.
RESEARCH DESIGN AND METHODS —In a prospective, observational case-control study, 42 type 2 diabetic patients were examined at baseline and 1, 3, 6, 12,
24, and 36 months after change to insulin therapy. Retinopathy was graded based on fundus photographs using the Wisconsin
scale; HbA 1c and IGF-1 were measured.
RESULTS —During the observation period of 3 years, 26 patients progressed in the retinopathy scale; 11 patients progressed at least
three levels. After 3 years of insulin therapy, HbA 1c and IGF-1 were significantly lower than at baseline. Progression of retinopathy greater than or equal to three levels was
related to high IGF-1 levels.
CONCLUSIONS —A relationship was found between high IGF-1 levels at 3 years and progression of retinopathy in type 2 diabetic patients.
DR, diabetic retinopathy
GH, growth hormone
PDR, proliferative diabetic retinopathy
Footnotes
Address correspondence and reprint requests to Marianne Henricsson, Department of Ophthalmology, S-25187 Helsingborg, Sweden.
E-mail: m.henricsson{at}telia.com .
Received for publication 13 June 2001 and accepted in revised form 16 October 2001.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.