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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a study of the retinopathy profile of 40 patients with tropical pancreatic diabetes, a form of secondary diabetes seen in tropical countries, diabetic retinopathy was detected in 13 patients. Ten patients had background retinopathy and three patients had proliferative retinopathy requiring laser photocoagulation. In two patients, fibrous retinitis proliferans was present. Three patients had evidence of diabetic maculopathy. To our knowledge, this is the first report of severe and sight-threatening retinopathy occurring with secondary diabetes. Retinopathy in these forms of diabetes has hitherto been considered to be rare or, if present, only of a mild background type.
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PMID:Retinopathy in tropical pancreatic diabetes. 405 52

The effect of strict metabolic control for 1 yr on renal function and retinal morphology was estimated in 24 insulin-dependent diabetic individuals (age 29 +/- 8 yr, diabetes duration 10 +/- 6 yr) 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 and glomerular filtration rates (GFR) were found to decline (from 130 +/- 18 to 116 +/- 15 ml/min/1.73 m2, P less than 0.01). The mean value of urinary albumin excretion (UAE) was not statistically significantly reduced (from 15.3 +/- 24.1 to 6.8 +/- 1.5 mg/24 h, P greater than 0.1). In the CIT group both GFR and UAE values were unchanged. In all subjects before treatment we found a positive correlation between the metabolic status, estimated by the HbA1c values, and GFR as well as UAE values, respectively (r = 0.64, P less than 0.01 and r = 0.42, P less than 0.05). We conclude that elevated GFR values can be reduced toward normal level by insulin pump treatment for 1 yr. Retinal morphology was found to deteriorate in four of 12 CIT subjects and in three of 12 CSII subjects. However, the progression was mild and in most individuals only due to a slight increase in the number of microaneurysms. Pump treatment did not induce proliferation and "cotton-wool" exudates were not detectable in any pump subject after 1 yr of treatment. We conclude that CSII treatment for 1 yr was unable to stop the progression of retinopathy in individuals with minimal or no retinopathy on entering the study. On the other hand, pump treatment did not induce cotton-wool exudates or proliferation in these subjects as previously reported in subjects with more severe retinopathy before CSII treatment.
Diabetes Care
PMID:Effect of insulin pump treatment for one year on renal function and retinal morphology in patients with IDDM. 407 44

A retrospective 5-year study examined the relationship between blood pressure and the severity and progression of mild background retinopathy in 48 patients with non-insulin-dependent diabetes and 38 with insulin-dependent diabetes who did not receive treatment in either eye for at least 3 years from their initial visit. All patients had annual medical and ophthalmic examinations including fundus photography. Retinopathy was assessed from fundus photographs using the Hammersmith grading system. Initial mean systolic and diastolic blood pressures (mm Hg) were significantly higher in those with non-insulin-dependent diabetes (149/88) than in patients with insulin-dependent diabetes (129/81). The former had significantly worse retinopathy than the latter initially and at 5 years. When non-insulin-dependent patients were grouped according to systolic blood pressure, those with readings above 160 mm Hg had significantly more severe retinopathy than those with readings below 140 mm Hg. Blood pressures initially and at 3 years were not significantly different between patients who received photocoagulation (five with insulin-dependent and six with non-insulin-dependent diabetes and those who did not in either group. There was significant correlation between systolic blood pressure and severity of retinopathy in patients with non-insulin-dependent disease, but the change in severity of retinopathy at 5 years did not correlate with blood pressure in either group.
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PMID:Blood pressure and the progression of mild background diabetic retinopathy. 407 41

We studied the relationship of intraocular pressure responsiveness to topical corticosteroids and the development of retinopathy in 86 patients with insulin-dependent juvenile-onset diabetes available for long-term follow-up and examination during 1982. Eleven patients had background retinopathy at the initial examinations. High (GG) and intermediate (NG) corticosteroid responsiveness was more common in these 86 patients (13 high responders and 39 intermediate responders) than in previously reported volunteer series. Background diabetic retinopathy was present at the end of the study in 75 of the 86 patients and proliferative retinopathy was present in 29. The proportions of patients developing either type of retinopathy were similar among the low (NN), intermediate, and high response groups. The rate of diabetic retinopathy development was related to the duration of the disease and not to the intraocular pressure response to topical corticosteroids.
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PMID:Lack of correlation between ocular hypertensive response to topical corticosteroids and progression of retinopathy in insulin-dependent diabetes mellitus. 634 87

The records of 23 insulin-dependent diabetics who had serial ophthalmological examinations during pregnancy and afterwards were reviewed. Fourteen pregnancies occurred in 10 patients with no retinopathy; 30% of these patients had obstetric complications. The mean birthweight was 3.5 kg. Ophthalmological status was unchanged in this group. In eight patients with background retinopathy during 10 pregnancies the obstetric complication rate was 70% and mean birthweight 3.3 kg. During pregnancy there was no evidence of progression of retinopathy. One patient developed proliferative retinopathy 4 years later. Five patients had proliferative retinopathy. The mean age (32 years) and duration of diabetes at index pregnancy (18 years) was greater than for the other groups. All patients developed pre-eclampsia and mean birthweight was 2.8 kg. Four of these patients required argon laser photocoagulation in association with pregnancy for progressive retinopathy; one died subsequently from end-stage diabetic nephropathy; the other four have maintained their pre-pregnancy visual acuity from 4 to 10 years.
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PMID:Diabetic retinopathy in pregnancy. 636 12

The course of diabetic retinopathy was investigated in 215 out of 227 insulin-treated diabetics in a one year epidemiological cohort study. Twelve diabetics, all with an onset age greater than or equal to 30 years, could not be re-examined due to deaths in 11 diabetics and deny in 1 diabetic. At the one year follow-up no change (P greater than 0.10) occurred in the prevalence of background retinopathy (50.0% vs 51.6%) or of proliferative retinopathy (16.3% vs 18.6%). The one year incidence of newly developed background retinopathy was 3.7% and of deteriorated retinopathy 10.7%. Newly developed proliferative retinopathy was found in 2.3% of the diabetics after one year. Deterioration of pre-existing background retinopathy developed most frequently among diabetics with a diabetes duration above 10 years. Deterioration of both background retinopathy and proliferative retinopathy showed a sudden onset in some diabetics. Partial sight and legal blindness caused by diabetic retinopathy developed in 3.7% of the diabetics, respectively.
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PMID:Diabetic retinopathy I. The course of retinopathy in insulin-treated diabetics. A one year epidemiological cohort study of diabetes mellitus. The Island of Falster, Denmark. 637 64

To look for possible determinators of the pathological readings of vitreous fluorophotometry in diabetes reported by other groups, we studied 32 insulin-treated patients, 22 of whom had fluorescein angiograms without pathological changes, while 10 had background retinopathy. 14 healthy subjects matched for age and blood pressure served as controls. Sodium fluorescein, 17 mg/kg body weight, was injected intravenously and ocular fluorophotometry performed 60 and 120 minutes later. Blood drawn 5, 45 and 120 minutes after the injection was assayed for total and ultrafiltrable fluorescein and the intraocular readings corrected for average preceding free plasma fluorescein. Patients without retinopathy did not differ from controls in any intraocular measure, while patients with retinopathy showed significantly increased readings in the posterior (60 min: 12 +/- 7 vs. 6 +/- 4, p less than 0.01, 120 min: 26 +/- 35 vs. 11 +/- 5, p less than 0.05) and middle vitreous (60 min: 6 +/- 3 vs. 3 +/- 3, p less than 0.001, 120 min: 11 +/- 5 vs. 8 +/- 5, p less than 0.01 (X 10(-9) g/ml fluorescein, mean +/- SD)). No significant relations to systolic or diastolic blood pressure, blood glucose, hemoglobin Alc or serum creatinine were found in any of the diabetic groups. Re-examination of 7 patients 4-14 days later in a non-fasting state showed no significant changes.
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PMID:Ocular fluorophotometry in insulin-treated diabetic patients with and without retinopathy. 638 56

Arachidonic acid uptake activity was measured in platelets obtained from 27 Type 2 diabetic patients and 18 age-matched control subjects. In both groups after 1 h incubation almost all the incorporated 14C-arachidonic acid was located in the phospholipids of the platelets. Arachidonic acid was predominantly incorporated into phosphatidylcholine. The radioactivity incorporated into platelets increased linearly with incubation time, up to 90 min. The linear increase was observed at arachidonic acid concentrations of 0.1-1.0 micrograms/ml in both groups. The rate of incorporation of radioactivity in diabetic platelets was about 1.4 times higher than that in control platelets at all arachidonic acid concentrations studied. The arachidonic acid uptake activity of diabetic platelets (577 +/- 26 ng/60 min per 10(9) platelets) was significantly higher than that in control platelets (410 +/- 26 ng/60 min per 10(9) platelets). No significant correlations were found between the arachidonic acid uptake activity and fasting plasma glucose, total cholesterol or triglyceride levels. The arachidonic acid uptake activity of platelets was significantly higher in diabetic patients with proliferative retinopathy than in those with little or no background retinopathy. In addition, there were no significant differences between control and diabetic subjects in the uptake activity of platelets for linoleic acid and oleic acid. These data may explain the elevated arachidonic acid content in diabetic platelet phospholipids and enhancement of thromboxane synthesis in diabetes.
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PMID:Increased arachidonic acid incorporation into platelet phospholipids in type 2 (non-insulin-dependent) diabetes. 642 1

Spontaneous platelet aggregation (SPA), a phenomenon observed in vitro, was noted in 29 of 74 (39%) children and adolescents with insulin-dependent diabetes. Its occurrence was independent of age of onset, duration of diabetes, HbAI levels or presence of background retinopathy but varied between normal and abnormal in given individuals tested repeatedly over some time. Plasma beta-thromboglobulin, the platelet protein specific for Phase II of the release reaction, was elevated in the diabetic subjects but was independent of the occurrence of SPA. SPA in the diabetic children and adolescents, in contrast to SPA in other conditions, was not suppressed by either acute or chronic administration of aspirin adequate to suppress ADP induced second wave aggregation. SPA was uniformly suppressed by addition to the in vitro system of EDTA, adenosine, antisera to human fibrinogen or vitamin E. The data suggest that SPA is ADP induced and reflects either abnormal platelet membrane permeability to the nucleotide or its abnormal release, or abnormal platelet sensitivity to normal plasma levels of ADP.
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PMID:Some characteristics of spontaneous platelet aggregation in young insulin-dependent diabetic subjects. 645 81

The overall prevalences of microvascular complications and their association with dietary, clinical, and metabolic characteristics have been studied in 503 Mexican type II diabetic subjects. Average daily dietary intakes were 1866 kcal, 46.5% as carbohydrate, 13.7 mmol cholesterol, 8.7 g fiber, and a polyunsaturated/saturated fat ratio of 0.98. Prevalence rates of microvascular and metabolic complications were as follows: background retinopathy 12.3%, exudative retinopathy 24.2%, proliferative retinopathy 8.1% (1% blind, 4% able to read large print only), 9.1% of patients had cataract, 15.9% nephropathy, and 40.8% peripheral neuropathy. In addition, 3.6% had experienced transient lower motor neuron facial paralysis and 0.2% oculomotor paralysis. Patients with retinopathy had a longer mean duration of diabetes, were less obese at the time of examination, and had higher initial and mean blood pressures and higher mean fasting blood glucose levels when compared with those without retinopathy. Similar differences were observed between groups with and without nephropathy except that mean blood glucose levels were similar in the two groups. The presence of peripheral neuropathy was associated with longer duration of diabetes, less obesity, higher mean blood pressure and mean blood glucose levels, and lower hemoglobin concentration. Patients treated with diet alone had significantly lower prevalences of all three microvascular complications but they also had significantly shorter duration of diabetes and lower mean blood glucose levels. However, multivariate analyses on the subgroup of 360 patients who had repeated fasting blood glucose measurements for at least 5 yr demonstrated associations between retinopathy and duration of diabetes, mean blood pressure and mean blood glucose, and percent calories from carbohydrate.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes Care
PMID:Association of differing dietary, metabolic, and clinical risk factors with microvascular complications of diabetes: a prevalence study of 503 Mexican type II diabetic subjects. II. 649 36


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