Effect of near normoglycaemia for two years on progression of early diabetic retinopathy, nephropathy, and neuropathy: the Oslo study

Forty five insulin dependent diabetics were randomised to treatment with continuous subcutaneous insulin infusion (CSII), multiple insulin injections (five or six daily), or conventional twice daily insulin injections. Near normoglycaemia was obtained with CSII and multiple injections but not with c...

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Bibliographic Details
Published in:BMJ 1986-11, Vol.293 (6556), p.1195-1199
Main Authors: Dahl-Jørgensen, K, Brinchmann-Hansen, O, Hanssen, K F, Ganes, T, Kierulf, P, Smeland, E, Sandvik, L, Aagenaes, O
Format: Article
Language:English
Subjects:
Blood glucose
Blood Glucose - metabolism
Clinical Trials as Topic
Diabetes
Diabetes complications
Diabetes mellitus
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - drug therapy
Diabetes Mellitus, Type 1 - physiopathology
Diabetic nephropathies
Diabetic Nephropathies - etiology
Diabetic Neuropathies - etiology
Diabetic Retinopathy - etiology
Excretion
Hemorrhage
Humans
Hyperglycemia - complications
Insulin
Insulin - administration & dosage
Insulin Infusion Systems
Kidney - physiopathology
Nerves
Random Allocation
Type 1 diabetes mellitus
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Summary:Forty five insulin dependent diabetics were randomised to treatment with continuous subcutaneous insulin infusion (CSII), multiple insulin injections (five or six daily), or conventional twice daily insulin injections. Near normoglycaemia was obtained with CSII and multiple injections but not with conventional treatment (p less than 0.01). Hypoglycaemic coma was observed less frequently with CSII than with multiple injections and conventional treatment (p less than 0.001), but blood glucose concentrations below 2.5 mmol/l (45 mg/100 ml) were more common. After two years fewer retinal microaneurysms and haemorrhages had developed in the patients given CSII and multiple injections compared with those given conventional treatment, in whom the number had increased significantly (p less than 0.01). Motor nerve conduction velocity deteriorated in the patients given conventional treatment; in those given CSII it was unchanged during the first year but had improved after two years (p less than 0.01). Glomerular hyperfiltration was reduced with CSII, but no change occurred in urine albumin excretion rates. Long term near normoglycaemia may prevent the progression of early stages of late diabetic complications.
ISSN:0267-0623
0959-8138
1468-5833
DOI:10.1136/bmj.293.6556.1195