Endocrine Abstracts

Introduction

Diabetic retinopathy is a serious complication of type 2 diabetes, which compromise the visual function and impair the quality of life of these patients. A rapid lowering of blood glucose especially when starting insulin therapy can worsen this retinopathy. We studied the variation of the initial daily insuline dose in the presence of diabetic retionopathy.

Methods

Our study is prospective randomized and comparative. We recruited patients with type 2 diabetes hospitalized for a switching to insulin in the C department of diabetology and nutrition at the national nutrition institute in Tunis, during 6 months, we compared the average of the initial daily insuline dose calculated on the day of discharge between the group with diabetic retionopathy and the group not affected using the Mann Whitney test.

Results

We included 50 patients with type 2 diabetes, 54% were men and 46% were women, with an average age of 59 years ( ± 10.7), the averge duration of diabetes was eight years ( ± 7).32% (95% CI 20–46) had diabetic retinopathy. The average of initial daily insuline dose was 0.42 IU/kg/d (95% CI 0.4–0.5) in the group not having diabetic retinopathy and it was 0.47 IU/kg/d (95% CI 0.4–0.6) in the affected group. No significant difference was found (P = 0.58).

Conclusion

This study did not show a variation in the initial daily insuline dose in the presence of diabetic retinopathy. Long-term ophthalmological follow-up of patients with retinopathy is necessary to judge the effect of a rapid lowernig of glucose serum level on this complication.