Glucose variability and inner retinal sensory neuropathy in persons with type 1 diabetes mellitus

• Published in: Eye (London) 2016-06, Vol.30 (6), p.825-832
• Main Authors: Stem, M S, Dunbar, G E, Jackson, G R, Farsiu, S, Pop-Busui, R, Gardner, T W
• Format: Article
• Language: English
• Subjects: 692/699/2743/137/138; 692/699/3161/3175; Adult; Blood Glucose - metabolism; Clinical Study; Contrast Sensitivity - physiology; Dark Adaptation - physiology; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - physiopathology; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - physiopathology; Female; Glycated Hemoglobin A - metabolism; Glycemic Index - physiology; Humans; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Pharmaceutical Sciences/Technology; Retina - physiopathology; Surgery; Surgical Oncology; Tomography, Optical Coherence; Visual Field Tests
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2016.48

Purpose To quantify early neuroretinal alterations in patients with type 1 diabetes mellitus (T1DM) and to assess whether glycemic variability contributes to alterations in neuroretinal structure or function. Methods Thirty patients with T1DM and 51 controls underwent comprehensive ophthalmic examination and assessment of retinal function or structure with frequency doubling perimetry (FDP), contrast sensitivity, dark adaptation, fundus photography, and optical coherence tomography (OCT). Diabetic participants wore a subcutaneous continuous glucose monitor for 5 days, from which makers of glycemic variability including the low blood glucose index (LGBI) and area under the curve (AUC) for hypoglycemia were derived. Results Sixteen patients had no diabetic retinopathy (DR), and 14 had mild or moderate DR. Log contrast sensitivity for the DM group was significantly reduced (mean±SD=1.63±0.06) compared with controls (1.77±0.13, P