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Effect of near normoglycemia for 5 years on progression of early diabetic retinopathy and renal involvement.
Diabetes Res. 1990 Dec; 15(4):185-90.DR

Abstract

The effect of strict metabolic control for 5 years on renal function and retinal morphology was estimated in 24 insulin-dependent diabetic individuals (age 29 +/- 8 years, diabetes duration 10 +/- 6 years) with albustix negative urine and minimal or no background retinopathy before the study. They were randomized to conventional insulin treatment (CIT) or continuous subcutaneous insulin infusion (CSII) with a portable pump. During CSII treatment the metabolic status was significantly improved. HbA1c fell from 8.9 +/- 2.0 to 7.4 +/- 1.3% (p less than 0.01) whereas HbA1c was unchanged during CIT treatment. The mean value of urinary albumin excretion (UAE) was not statistically significantly changed (from 12 +/- 10 mg/24 h to 13 +/- 5 mg/24 h in CSII patients and from 14 +/- 12 to 11 +/- 6 mg/24 h in CIT patients (p greater than 0.1). On the other hand, the elevated GFR values were significantly reduced in both CSII and CIT patients, 129 +/- 17 to 120 +/- 9 and 129 +/- 18 to 119 +/- 12 ml/min.1,73m2, respectively (p less than 0.05). Both the number of microaneurysms, haemorrhages and exudates tended to increase mor in CIT patients than in CSII patients during the 5 year study period, but the differences did not reach statistically significance (p greater than 0.1). Pump treatment did not induce proliferations or "cotton wool" exudates. We conclude that no statistically significantly differences between GFR values, UAE rates, and progression of background retinopathy was observed between normoalbuminuric IDDM patients treated for 5 years with CIT and CSII, respectively. However, due to the size of the material a type II error must be taken into consideration.

Authors+Show Affiliations

Beck-Nielsen H
Medical Endocrinological Department III, Aarhus County Hospital, Denmark.
Olesen T
No affiliation info available
Mogensen CE
No affiliation info available
Richelsen B
No affiliation info available
Olsen HW
No affiliation info available
Ehlers N
No affiliation info available
Charles P
No affiliation info available
Sørensen NS
No affiliation info available

MeSH

AdultAlbuminuriaBlood GlucoseBlood PressureDiabetes Mellitus, Type 1Diabetic NephropathiesDiabetic RetinopathyFemaleFluorescein AngiographyFollow-Up StudiesGlomerular Filtration RateHumansInsulinInsulin Infusion SystemsKidneyMaleRetina

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

2132407

Citation

Beck-Nielsen, H, et al. "Effect of Near Normoglycemia for 5 Years On Progression of Early Diabetic Retinopathy and Renal Involvement." Diabetes Research (Edinburgh, Scotland), vol. 15, no. 4, 1990, pp. 185-90.
Beck-Nielsen H, Olesen T, Mogensen CE, et al. Effect of near normoglycemia for 5 years on progression of early diabetic retinopathy and renal involvement. Diabetes Res. 1990;15(4):185-90.
Beck-Nielsen, H., Olesen, T., Mogensen, C. E., Richelsen, B., Olsen, H. W., Ehlers, N., Charles, P., & Sørensen, N. S. (1990). Effect of near normoglycemia for 5 years on progression of early diabetic retinopathy and renal involvement. Diabetes Research (Edinburgh, Scotland), 15(4), 185-90.
Beck-Nielsen H, et al. Effect of Near Normoglycemia for 5 Years On Progression of Early Diabetic Retinopathy and Renal Involvement. Diabetes Res. 1990;15(4):185-90. PubMed PMID: 2132407.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of near normoglycemia for 5 years on progression of early diabetic retinopathy and renal involvement. AU - Beck-Nielsen,H, AU - Olesen,T, AU - Mogensen,C E, AU - Richelsen,B, AU - Olsen,H W, AU - Ehlers,N, AU - Charles,P, AU - Sørensen,N S, PY - 1990/12/1/pubmed PY - 1990/12/1/medline PY - 1990/12/1/entrez SP - 185 EP - 90 JF - Diabetes research (Edinburgh, Scotland) JO - Diabetes Res VL - 15 IS - 4 N2 - The effect of strict metabolic control for 5 years on renal function and retinal morphology was estimated in 24 insulin-dependent diabetic individuals (age 29 +/- 8 years, diabetes duration 10 +/- 6 years) with albustix negative urine and minimal or no background retinopathy before the study. They were randomized to conventional insulin treatment (CIT) or continuous subcutaneous insulin infusion (CSII) with a portable pump. During CSII treatment the metabolic status was significantly improved. HbA1c fell from 8.9 +/- 2.0 to 7.4 +/- 1.3% (p less than 0.01) whereas HbA1c was unchanged during CIT treatment. The mean value of urinary albumin excretion (UAE) was not statistically significantly changed (from 12 +/- 10 mg/24 h to 13 +/- 5 mg/24 h in CSII patients and from 14 +/- 12 to 11 +/- 6 mg/24 h in CIT patients (p greater than 0.1). On the other hand, the elevated GFR values were significantly reduced in both CSII and CIT patients, 129 +/- 17 to 120 +/- 9 and 129 +/- 18 to 119 +/- 12 ml/min.1,73m2, respectively (p less than 0.05). Both the number of microaneurysms, haemorrhages and exudates tended to increase mor in CIT patients than in CSII patients during the 5 year study period, but the differences did not reach statistically significance (p greater than 0.1). Pump treatment did not induce proliferations or "cotton wool" exudates. We conclude that no statistically significantly differences between GFR values, UAE rates, and progression of background retinopathy was observed between normoalbuminuric IDDM patients treated for 5 years with CIT and CSII, respectively. However, due to the size of the material a type II error must be taken into consideration. SN - 0265-5985 UR - https://www.unboundmedicine.com/medline/citation/2132407/Effect_of_near_normoglycemia_for_5_years_on_progression_of_early_diabetic_retinopathy_and_renal_involvement_ DB - PRIME DP - Unbound Medicine ER -