Effect of insulin infusion pump use on diabetic retinopathy
T. M. Kelly, G. E. Sanborn, P. J. Haug and C. Q. Edwards
Ten patients with insulin-dependent diabetes mellitus (IDDM) had fundus
photographs and fluorescein angiograms obtained before and after a control
period characterized by conventional insulin injections and a test period
characterized by continuous subcutaneous insulin infusion (CSII). The mean
glycosylated hemoglobin value at the end of the control period was 14.3%
+/- 3.8% and decreased to 10.1% +/- 3.3% at the end of the test period.
During the control period, none of the patients' eyes changed more than one
grade in a modified Early Treatment Diabetic Retinopathy Study
classification. All seven eyes without retinopathy at the start of the
control period were still without retinopathy at its completion. One eye
improved three grades during the test period, but four eyes, including two
without retinopathy when CSII was initiated, progressed one grade. The data
suggest that metabolic control that is improved but not normalized by CSII
neither reverses retinopathy in IDDM nor prevents its development.
