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Two-Year Experience with Continuous Subcutaneous Insulin Infusion in Relation to Retinopathy and Neuropathy
Abstract
Thirty patients with insulin-dependent diabetes mellitus (IDDM) who had advanced background retinopathy were randomized to unchanged conventional treatment (UCT) or to continuous subcutaneous insulin infusion (CSII). They were followed prospectively for 2 yr. The mean blood glucose and hemoglobin A1c (HbA1c) were significantly lower in the CSII group than in the UCT group. The mean blood glucose and HbA1c did not change from the first to the second year in either of the treatment groups in spite of less frequent home-monitoring of blood glucose and less frequent outpatient visits during the second year. Four patients in the CSII group and five in the UCT group developed proliterative retinopathy. However, a marginally significant trend was found toward more frequent improvement of retinal morphology in the CSII group (47%) than in the UCT group (13%). Beat-to-beat variation was found to deteriorate significantly with UCT compared with a nonsignificant improvement with CSII therapy. Vibration sense was unchanged in both treatment groups. It is concluded that near-normal blood glucose levels can be maintained with CSII therapy in spite of less frequent home-monitoring of blood glucose and outpatient visits. Furthermore, established background retinopathy may progress to proliferative retinopathy in spite of 2 yr of near-normal blood glucose levels. However, a marginally significant trend toward more frequent improvement of retinal morphology was found among CSII-treated patients compared with conventionally treated patients. Large-scale, prospective, randomized studies are needed to confirm these results.
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Cited by
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Self-citationEarly Worsening of Diabetic Retinopathy in the Diabetes Control and Complications Trial
(1998) · Archives of Ophthalmology · doi:10.1001/archopht.116.7.874 · Cited by 509
Self-citationFeldt-Rasmussen, B., Mathiesen, E., & Deckert, T. (1986) · The Lancet · doi:10.1016/s0140-6736(86)91433-9 · Cited by 447
Self-citationWANG, P. (1993) · The Lancet · doi:10.1016/0140-6736(93)90816-y · Cited by 446
Overexpression of Fibronectin Induced by Diabetes or High Glucose: Phenomenon With a Memory
Roy, S., Sala, R., Cagliero, E., & Lorenzi, M. (1990) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.87.1.404 · Cited by 409
Misso, M. L., Egberts, K. J., Page, M., O'Connor, D., & Shaw, J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005103.pub2 · Cited by 406
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Semaglutide, reduction in glycated haemoglobin and the risk of diabetic retinopathy
Vilsbøll, T., Bain, S. C., Leiter, L. A., Lingvay, I., Matthews, D., Simó, R., Helmark, I. C., Wijayasinghe, N., & Larsen, M. (2018) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.13172 · Cited by 318
Intensive glucose control versus conventional glucose control for type 1 diabetes mellitus
Fullerton, B., Jeitler, K., Seitz, M., Horvath, K., Berghold, A., & Siebenhofer, A. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009122.pub2 · Cited by 299
Smits, M. M., & Van Raalte, D. H. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.645563 · Cited by 332
Mukhopadhyay, A., Farrell, T., Fraser, R. B., & Ola, B. (2007) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2007.03.062 · Cited by 153
Bethel, M. A., Diaz, R., Castellana, N., Bhattacharya, I., Gerstein, H. C., & Lakshmanan, M. C. (2021) · Diabetes Care · doi:10.2337/dc20-1815 · Cited by 151
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The Stockholm Diabetes Intervention Study (SDIS): 18 months' results
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The Influence of Glucose Concentration and Hypoxia on VEGF Secretion by Cultured Retinal Cells
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Metadata
- Authors
- Lauritzen, T., Frost-Larsen, K., Larsen, H.-W., Deckert, T., & The Steno Study Group
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 1985-08-01
- Volume
- 34
- Issue
- Supplement_3
- Pages
- 74-79
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2313488710
- Cited by
- 252
- References
- 0
- FWCI
- 12.83
- Type
- journal article
- Language
- en
- Open access
- closed
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