Cited by 490Retinal Diseases and TreatmentsDiabetes Management and ResearchAdvanced Glycation End Products research

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Progression of Incipient Diabetic Retinopathy During Good Glycemic Control

Engerman, Ronald L, Kern, Timothy S·1987·Diabetes

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Abstract

To assess the extent to which the progression of diabetic retinopathy can be arrested by improved glycemic control, 35 normal dogs were randomly divided into a nondiabetic and three alloxan-induced diabetic groups prospectively identified according to glycemic control: poor control for 5 yr (PC), good control for 5 yr (GC), and poor control for 2.5 yr followed by good control for 2.5 yr (PGC). To achieve good control, insulin was given twice daily together with a measured diet so that hyperglycemia and glucosuria were mild and infrequent, and HbA1 was comparable to normal. Retinal capillary aneurysms and other lesions developed during 60 mo of poor control (group PC) and were inhibited if good control was begun promptly within 2 mo (group GC). In group PGC, retinopathy was absent or equivocal at 2.5 yr of poor control and, surprisingly, was found to develop subsequently despite good glycemic control. Retinopathy in group PGC was greater at autopsy than at 2.5 yr and was greater than in group GC. The results indicate that retinopathy may be preventable but tends to resist arrest even in its incipient stages, before more than the first few aneurysms have appeared.

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Crossref · 10.2337/diab.36.7.808

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Self-citation
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BackgroundInfluential
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“The concept was initially described more than 30 years ago by studying the retinopathy in dogs with diabetes treated with different blood glucose targets over time.(12) Similarly, the remnant toxic effect of high glucose exposure was reported on cultured human endothelial cells.”
Background
Anti-angiogenic therapy of proliferative diabetic retinopathy
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“Evidence for such memory has been shown in both human diabetic subjects and chemically-induced diabetic animal models [17,18].”
Background
Termination of experimental galactosemia in rats, and progression of retinal metabolic abnormalities.
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Effect of galactose diet removal on the progression of retinal vessel changes in galactose-fed dogs.
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DIABETIC EYE DISEASE
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The Amelioration of Detrimental Biochemical Anomalies by Supplementing B, C, and E Vitamins in Subjects with Type 2 Diabetes Mellitus May Reduce the Rate of Development of Diabetic Retinopathy
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“Though duration and uncontrolled hyperglycemia are considered to be the contributors to the pathogenesis of DR, some individuals with T2DM keep away from the development of complications from this disease for a prolonged period [1, 2].”
Background
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Insulin treatment normalizes retinal neuroinflammation but not markers of synapse loss in diabetic rats
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“…demonstrate the metabolic memory phenomenon whereby a period of poor glycemic control continues to confer a higher disease risk even after establishment of good glycemic control (Aiello and DCCT/EDIC Research Group, 2014; Engerman and Kern, 1987; Intine and Sarras, 2012; Pirola et al., 2010).”

Authors: Engerman, R. L., & Kern, T. S.
Affiliations: University of Wisconsin–Madison (US)
ORCID: Kern, Timothy S
Venue: Diabetes
Publisher: American Diabetes Association
Published: 1987-07-01
Volume: 36
Issue: 7
Pages: 808-812
ISSN: 0012-1797 (ISSN-L)
1939-327X
DOI: 10.2337/diab.36.7.808
OpenAlex: W2104738423
Cited by: 490
References: 0
Citations by year: 2026: 7 · 2025: 10 · 2024: 15 · 2023: 13 · 2022: 12 · 2021: 13 · 2020: 13 · 2019: 16 · 2018: 11 · 2017: 16 · 2016: 14 · 2015: 25 · 2014: 26 · 2013: 22 · 2012: 17
FWCI: 13.21
Type: journal article
Language: en
Open access: closed
Locations: Diabetes (publishedVersion)
PubMed (publishedVersion)
Funders: National Eye Institute (EY00 300)
Topics: Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
Keywords: diabetic retinopathy, disease progression, glycemic control, alloxan-induced diabetes, insulin therapy, HbA1c, glycosuria, retinopathy prevention, dogs
MeSH terms: Aneurysm, Animals, Autopsy, Blood Glucose, Capillaries, Diabetic Retinopathy, Dogs, Female, Hyperglycemia, Insulin, Male, Retina

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Progression of Incipient Diabetic Retinopathy During Good Glycemic Control

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