Rapid tightening of blood glucose control leads to transient deterioration of retinopathy in insulin dependent diabetes mellitus: the Oslo study.
Open accessAbstract
In a study of retinopathy during one year of tight blood glucose control 45 type I (insulin dependent) diabetics without proliferative retinopathy were randomised to receive either continuous subcutaneous insulin infusion, multiple insulin injections, or conventional insulin treatment (controls). Near normoglycaemia was achieved with continuous infusion and multiple injections but not with conventional treatment. Blind evaluation of fluorescein angiograms performed three monthly showed progression of retinopathy in the control group, transient deterioration in the continuous infusion group, and no change in the multiple injection group. Half the patients receiving continuous infusion and multiple injections developed retinal cotton wool spots after three to six months. These changes regressed in all but four patients after 12 months. Control patients did not develop cotton wool spots. Patients who developed cotton wool spots are characterised by a larger decrement in glycosylated haemoglobin and blood glucose values, more frequent episodes of hypoglycaemia, a longer duration of diabetes, and more severe retinopathy at onset. A large and rapid fall in blood glucose concentration may promote transient deterioration of diabetic retinopathy.
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An association between rapid glucose lowering and worsening of retinopathy has been reported in patients with type 1 diabetes.
“An association between rapid glucose lowering and worsening of retinopathy has been reported in patients with type 1 diabetes.9,10”
From Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes (2016) · cites this paper as [10]
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Research works printed but not linked: 14
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- Authors
- Dahl-Jørgensen, K., Brinchmann-Hansen, O., Hanssen, K. F., Sandvik, L., & Aagenaes, O.
- Affiliations
- Oslo University Hospital (NO)
- ORCID
- Sandvik, L
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1985-03-16
- Volume
- 290
- Issue
- 6471
- Pages
- 811-815
- ISSN
- 0007-1447 (ISSN-L)
- 0267-0623
- 1468-5833
- OpenAlex
- W2044293101
- Cited by
- 360
- References
- 0
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 8 · 2023: 3 · 2022: 3 · 2021: 10 · 2020: 7 · 2019: 5 · 2018: 12 · 2017: 18 · 2016: 4 · 2015: 10 · 2014: 8 · 2013: 6 · 2012: 8
- FWCI
- 31.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- diabetic retinopathy, type 1 diabetes, insulin pump therapy, multiple daily insulin injections, retinopathy progression, glycosylated haemoglobin, hypoglycemia
- MeSH terms
- Adolescent, Adult, Blood Glucose, Diabetes Mellitus, Type 1, Diabetic Retinopathy, Female, Hemoglobin A, Humans, Infusions, Parenteral, Insulin, Male, Time Factors
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