Diabetic glycemic control and retinal blood flow.
The effect of strict glycemic control on retinal volumetric blood flow rate (Q) was investigated in 13 insulin-dependent diabetic patients with laser Doppler velocimetry and monochromatic fundus photography. Strict glycemic control was achieved by glucose monitoring and four daily insulin injections. Q was determined in a major retinal vein at baseline and then 5 days, 2 mo, and 6 mo after the institution of strict control. Level of retinopathy was assessed from stereocolor fundus photographs taken at baseline and 6 mo. After 6 mo of strict diabetic control, five eyes demonstrated progression (P) by one or more retinopathy levels, and eight eyes showed no progression (NP). At 5 days, there was a significant decrease in Q of 1.4 +/- 0.9 microliters/min (P less than 0.005) in NP eyes and a nonsignificant increase in Q of 1.2 +/- 1.7 microliters/min in P eyes. Changes in Q from baseline observed at 5 days were strongly correlated with changes in retinopathy level at 6 mo (r = 0.79, P less than 0.005). No significant changes in Q from baseline were observed at 2 and 6 mo. A lack of decrease in Q at 5 days was associated with the progression of retinopathy that occurs in some patients after the institution of strict glycemic control and may serve as a predictor for progression of retinopathy.
Department of Ophthalmology, Scheie Eye Institute, Philadelphia, PA 19104.
J E
JE
Grunwald
A J
AJ
Brucker
S S
SS
Schwartz
S N
SN
Braunstein
L
L
Baker
B L
BL
Petrig
C E
CE
Riva
D000328:Adult; D001783:Blood Flow Velocity; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D003930:Diabetic Retinopathy / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D012039:Regional Blood Flow; D012171:Retinal Vessels / Q000502:physiology*
D001786:Blood Glucose; D007328:Insulin