Diabetic retinopathy after one year of improved metabolic control obtained by continuous subcutaneous insulin infusion (CSII)

Twenty-four insulin dependent juvenile diabetics, with no or minimal background retinopathy, were randomly allocated to conventional insulin therapy (CIT) or continuous subcutaneous insulin infusion (CSII) administrated by means of a portable pump. The metabolic control was significantly improved in the CSII group as compared to the CIT group. After one year, a progression of diabetic retinopathy (criterion: development of more than 2 microaneurysms) was observed in 3 of 12 patients in the CSII group and in 4 of 12 patients in the CIT group (P greater than 0.05). A tendency to more severe progression was observed in the CIT group. None developed soft exudates or retinal proliferations. Although no significant beneficial effect of pump treatment could be demonstrated, it seems safe to conclude that pump treatment does not accelerate progression of diabetic retinopathy in patients with no or minimal background retinopathy.