Progression of diabetic retinopathy after pancreas transplantation for insulin-dependent diabetes mellitus

R. C. Ramsay, F. C. Goetz, D. E.R. Sutherland, S. M. Mauer, L. L. Robison, H. L. Cantrill, W. H. Knobloch, J. S. Najarian

Research output: Contribution to journalArticlepeer-review

283 Scopus citations

Abstract

We studied the effect of successful pancreas transplantation and consequent normoglycemia (mean total hemoglobin A1, 7.0 percent; range, 5.8 to 8.3) on visual function and diabetic retinopathy in 22 patients with Type I diabetes mellitus (study group). Sixteen similar patients in whom pancreas transplantation had been unsuccessful (mean total hemoglobin A1, 12.0 percent; range, 8.0 to 18.0) served as a control group. The majority of patients in both groups had advanced proliferative retinopathy. At a mean follow-up of 24 months we found no significant difference between the groups in the rate of progression of retinopathy, expressed as a score. Success of the transplantation did not prevent progression of retinopathy across the range of retinopathy studied. Progressive retinopathy was observed more commonly in patients with low retinopathy scores (nonproliferative or mild proliferative retinopathy) at base line in both the study group (13 of 17 eyes, or 76 percent) and the control group (7 of 12 eyes, or 58 percent). Further analysis suggested the possibility that after three years of euglycemia, the study group had less deterioration than the control group, particularly in eyes with advanced retinopathy. We observed no difference in the rate of loss of vision between the two groups. This study provides evidence that pancreas transplantation and subsequent normoglycemia neither reverse nor prevent the progression of diabetic retinopathy.

Original languageEnglish (US)
Pages (from-to)208-214
Number of pages7
JournalNew England Journal of Medicine
Volume318
Issue number4
DOIs
StatePublished - 1988

Fingerprint Dive into the research topics of 'Progression of diabetic retinopathy after pancreas transplantation for insulin-dependent diabetes mellitus'. Together they form a unique fingerprint.

Cite this