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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“This is especially true in diabetic patients for whom hyperglycemia is episodic, unlike the unremitting high-glucose environment of the animal models in which metabolic memory was characterized [202,205].”
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“We previously conducted 5 year studies of diabetic dogs to investigate the roles of glycemic control (Howell et al., 2013; Engerman and Kern, 1987) or experimental therapies (Kern and Engerman, 2001; Engerman and Kern, 1993) on the development of diabetic retinopathy, and showed that PC or MC…”
BackgroundSelf-citation
Selection of experimental models mimicking human pathophysiology for diabetic microvascular complications
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Self-citation
Insulin Treatment in the Elderly Diabetic Patient
Nathan, D. M. (1990) · Clinics in Geriatric Medicine · doi:10.1016/s0749-0690(18)30589-5 · Cited by 2

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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