Research article
High prevalence of proliferative retinopathy in diabetic patients with low pancreatic B-cell capacity

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Abstract

A retrospective study on the role of pancreatic B-cell insulin secretory capacity in the development of proliferative diabetic retinopathy was performed in 160 diabetic patients with a duration of diabetes of more than 10 years (mean 19.5 ± 7.9 years). Pancreatic B-cell insulin secretory capacity was assessed in terms of the quantity of C-peptide excreted into urine per day (24-h urinary C-peptide). When the patients were divided into three groups according to the quantity of 24-h urinary C-peptide (group I, C-peptide < 30 μg, n = 49; group II, 30 μg ≤ C-peptide < 80 μg, n = 76; and group III, C-peptide ≥ 80 μg, n = 35), the prevalence of proliferative diabetic retinopathy was much higher in group I (26.5%) than in group II (5.3%) or group III (2.9%). The incidence of proliferative diabetic retinopathy during the follow-up period (mean 9.8 ± 4.8 years) was also highest in group I (20.0%, 2.7%, and 2.9% in groups I, II, and III, respectively). Other factors which might affect the development of proliferative diabetic retinopathy, including duration of diabetes and past glycemic control, were comparable in these three groups. In contrast, a division of the patients according to glycemic control revealed a strong correlation between glycemic control and background diabetic retinopathy whereas no such correlation was apparent with proliferative diabetic retinopathy.

These data are consistent with the view that low pancreatic B-cell. insulin secretory capacity may be a risk factor for the development of proliferative diabetic retinopathy.

References (22)

  • P. Raskin

    Diabetic regulation and its relationship to microangiopathy

    Metabolism

    (1978)
  • G. Tchobrousky

    Relation of diabetic control to development of microvascular complications

    Diabetologia

    (1978)
  • R. Klein et al.

    The Wisconsin epidemiologic study of diabetic retinopathy III. Prevalence and risk of diabetic retinopathy when age at diagnosis is over 30 years

    Arch. Ophthalmol.

    (1981)
  • J. Howard-Williams et al.

    Retinopathy is associated with higher glycemia in maturity onset type diabetes

    Diabetologia

    (1984)
  • R.N. Frank et al.

    Retinopathy in juvenile onset type I diabetes of short duration

    Diabetes

    (1982)
  • M.A. Testa et al.

    Clinical predictors of retinopathy and its progression in patients with type I diabetes during CSII or conventional insulin treatment

    Diabetes

    (1985)
  • L.I. Rand et al.

    Multiple factors in the prediction of risk of proliferative diabetic retinopathy

    N. Engl. J. Med.

    (1985)
  • A.S. Krolewski et al.

    Risk of proliferative diabetic retinopathy in juvenile-onset type I diabetes: a 40-year follow-up study

    Diabetes Care

    (1986)
  • D.M. Nathan et al.

    Retinopathy in older type II diabetics; association with glucose control

    Diabetes

    (1986)
  • L.C. Groop et al.

    Risk factors and markers associated with proliferative retinopathy in patients with insulin-dependent diabetes

    Diabetes

    (1986)
  • D.A. Pyke et al.

    Diabetic retinopathy in identical twins

    Diabetes

    (1973)
  • Cited by (0)

    Present address: The 1 st Department of Internal Medicine, Toho University School of Medicine, 5-21-16, Ohmori-nishi, Ohta-ku, Tokyo 143, Japan

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