Key result
A lack of decrease in retinal volumetric blood flow rate at 5 days after instituting strict glycemic control was strongly correlated with retinopathy progression at 6 months (r = 0.79, P<0.005).
Why the study?
Does strict glycemic control alter retinal volumetric blood flow rate and predict retinopathy progression in insulin-dependent diabetic patients?
Cohort (n=13)
Does strict glycemic control alter retinal volumetric blood flow rate and predict retinopathy progression in insulin-dependent diabetic patients?
Effect estimate: r = 0.79
p-value: p=<0.005
A lack of early decrease in retinal blood flow after initiating strict glycemic control may serve as a predictor for the progression of diabetic retinopathy.
Lack of early retinal blood flow decrease may predict retinopathy progression after glycemic control; leaves open causality and clinical utility in prospective studies.
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.
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Grunwald et al. (1990) conducted a cohort in Insulin-dependent diabetes (n=13). Strict glycemic control was evaluated on Change in retinal volumetric blood flow rate (Q) at 5 days and correlation with retinopathy progression at 6 months (r = 0.79, p=<0.005). A lack of decrease in retinal volumetric blood flow rate at 5 days after instituting strict glycemic control was strongly correlated with retinopathy progression at 6 months (r = 0.79, P<0.005).
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