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COMMENTS AND OPINIONS
Association of Proliferative Diabetic Retinopathy With Insulin Use and Microalbuminuria—Reply
Lloyd Paul Aiello, MD, PhD;
Lucy Q. Shen, MD
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In reply
We thank Chu and Li for their comments regarding our article.1 The authors express concern that there is more insulin use in the control group than in the rosiglitazone-treated group, as would clearly be expected during therapy with an insulin sensitizer. They cite 2 studies2-3 indicating that insulin itself would induce the risk of PDR through effects on IGF-1. This association remains unclear. Although some studies have shown that IGF-1 is elevated in diabetic subjects compared with nondiabetic ones,2 other studies have not observed this.4-5 The association between PDR and IGF-1 is also unclear. One article cited by Chu and Li2 demonstrated decreasing levels of free and total IGF-1and increased levels of some IGF-binding proteins with diabetes, and concluded there was "no evidence of a direct role of free IGF-1 in the development of PDR," although IGF-binding proteins may . . . [Full Text of this Article]
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RELATED ARTICLE
Rosiglitazone and Delayed Onset of Proliferative Diabetic Retinopathy
Lucy Q. Shen, Angie Child, Griffin M. Weber, Judah Folkman, and Lloyd Paul Aiello
Arch Ophthalmol. 2008;126(6):793-799.
ABSTRACT
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RELATED LETTER
Association of Proliferative Diabetic Retinopathy With Insulin Use and Microalbuminuria
Shu-Hsun Chu and Ai-Hsien Li
Arch Ophthalmol. 2010;128(1):146.
EXTRACT
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