The Influence of Rapid Blood Glucose Control on Diabetic Retinopathy.
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概要
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We studied the adverse effect of rapid blood glucose control on the retina in non-insulin-dependent diabtics. Eighty nine patients with no diabetic retinopathy (NDR)[Group A] and 39 patients with simple diabetic retinopathy (SDR)[Group B] participated in this study. All subjects were hospitalized for a check-up and were then followed up for one year after discharge. The definition of rapid blood glucose control was an HbA<SUB>1</SUB>c level which decreased by more than 30% in three months. We also evaluated other clinical factors: age, sex, duration of diabetes, body mass index, blood pressure, Achilles' tendon reflex (ATR), microalbuminuria, proteinuria, methods of therapy, alcohol intake, and smoking habits. The HbAi c was measured every 3 months, while a retinal examination was done on admission and again one year after discharge. Of the 89 patients in Group A, 5 patients progressed to SDR and 2 patients to preproliferative retinopathy (PPDR). Of the 39 patients in Group B, 5 patients progressed to PPDR, while 9 patients improved to NDR. The deterioration in retinopathy occurred significantly more often in the patients in Group A (75%, p<0.01) than in Group B (36%) when rapid glucose control was achieved in patients without ATR. There was little effect of the rapid glucose control on retinopathy in patients with ATR. In the cases who remained as they were or who improved to NDR, the mean HbAic levels were less than 7% and were statistically lower (p <0.05) than those of the patients with retinopathy after one year.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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