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Intensive Insulin Therapy In Children And Adolescents With Type 1 Diabetes Reduces Lifetime Risk Of Retinopathy And Cataracts

Posted: Wednesday, October 06, 2004

The Diabetes Control and Complications Trial showed the unequivocal advantages of intensive insulin therapy in comparison with conventional insulin therapy. .

This newer study sets out to estimate the influence of the duration of conventional insulin therapy on the development of complications in patients with type 1 diabetes for more than 5 years.

185 patients averaging 16.7 years of age with diabetes onset of approximately 8 years participated in this study. 148 were treated by classic insulin therapy at the beginning of disease and 37 persons had intensive insulin therapy from the start.

The presence of at least one complication was found in 49 persons, two complications - in 14 patients and three complications in 4 patients. Patients who had developed retinopathy had remained on conventional therapy twice as long as the others. The significant influence of the age, the age of diabetes onset and duration was found in those patients. Patients treated conventionally for less than 3.5 years and then switched to intensive therapy had significantly less complications than those who stayed on conventional therapy longer. The risk of retinopathy increases from 4.2% to 8.9% in patients treated conventionally more than 3.5 years. The risk of diabetic cataract is 5 times higher in that group.

Chronic complications of diabetes occur in 26.5 % patients of all patients with diabetes duration of at least 5 years. Conventional Insulin Therapy is a major risk factor of the eye complications in diabetes. The prolongation of CIT over 3.5 years increases the risk of retinopathy twice and the risk of cataract 5 times in patients with type 1 diabetes. So the early intensification of insulin therapy reduces the risk of the retinopathy and cataract development in later course of the disease.

Source: Diabetes In Control.com: