Key result
Long-term insulin in T2D is linked to ~35% higher retinal artery pulsatility versus no insulin.
Why the study?
It was unknown whether long-term insulin treatment is associated with abnormalities in retinal circulation in patients with type 2 diabetes.
Does long-term insulin treatment increase retinal arterial stiffness (pulsatility ratio and resistance index) in patients with type 2 diabetes?
Cross-Sectional (n=87)
No
Does long-term insulin treatment increase retinal arterial stiffness (pulsatility ratio and resistance index) in patients with type 2 diabetes?
Absolute Event Rate: 5.8% vs 4.3%
p-value: p=<0.01
Long-term insulin treatment in patients with type 2 diabetes is associated with increased pulsatility ratio and resistance index of the retinal artery, suggesting elevated vascular rigidity.
Association with higher retinal indices in cross-sectional data warrants no practice change; leaves open causal effects on arterial stiffness.
This study aimed to evaluate whether long-term insulin treatment is associated with abnormalities in retinal circulation in type 2 diabetic patients. We evaluated 19 eyes of nondiabetic individuals and 68 eyes of type 2 diabetic patients. The eyes of diabetic patients were classified into two groups according to the presence or absence of long-term insulin therapy. We used a Doppler optical coherence tomography flowmeter to measure diameter, velocity, and blood flow in the major temporal retinal artery. The pulsatility ratio (PR) and resistance index (RI), indices of vascular rigidity, were calculated from the blood velocity profile. PR and RI were significantly elevated in type 2 diabetic patients compared with nondiabetic subjects (P < 0.05). In type 2 diabetes patients, PR and RI were significantly higher in patients receiving long-term insulin treatment than in those without (P < 0.01). There was a significant difference in velocity (P < 0.05), but not diameter and blood flow, between nondiabetic subjects and type 2 diabetes patients. No significant difference in diameter, velocity, or blood flow was observed between the groups with and without long-term insulin treatment. Long-term insulin treatment can affect PR and RI, which might be associated with vascular rigidity of the retinal artery in patients with type 2 diabetes.
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Omae et al. (2021) conducted a cross-sectional in Type 2 diabetes mellitus (n=87). Long-term insulin treatment vs. No insulin treatment was evaluated on Pulsatility ratio (PR) of the retinal artery (p=<0.01). Long-term insulin treatment in patients with type 2 diabetes was associated with significantly higher pulsatility ratio and resistance index of the retinal artery compared to those without insulin treatment (P < 0.01).
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