, Volume 29, Issue 10, pp 677–684 | Cite as

Diabetic control and microvascular complications: The near-normoglycaemic experience

  • K. F. Hanssen
  • K. Dahl-Jørgensen
  • T. Lauritzen
  • B. Feldt-Rasmussen
  • O. Brinchmann-Hansen
  • T. Deckert


Public Health Internal Medicine Human Physiology Metabolic Disease Diabetic Control 
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  1. 1.
    Tchobroutsky G (1978) Relation of diabetic control to development of microvascular complications. Diabetologia 15:143–152Google Scholar
  2. 2.
    Doft BH, Kingsley LA, Orchard TF, Kuller L, Drash A, Becker D (1984) The association between long-term diabetic control and early retinopathy. Ophthalmology 91: 763–769Google Scholar
  3. 3.
    Weber B, Burger W, Hartmann R, Hövener G, Malchus R, Oberdisse U (1986) Risk factors for the development of retinopathy in children and adolescents with type 1 (insulin-dependent) diabetes mellitus. Diabetologia 29: 23–29Google Scholar
  4. 4.
    Klein R, Klein BEK, Moss SE, Cavid MD, DeMets DL (1984) The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age of diagnosis is less than 30 years. Arch Ophthalmol 102: 520–526Google Scholar
  5. 5.
    Sjølie AK (1985) Ocular complications in insulin treated diabetes mellitus. Acta Ophthalmol 63 (Suppl 172)Google Scholar
  6. 6.
    Rand LI, Krolewski AS, Aiello LM, Warran JH, Baker RS, Maki T (1985) Multiple factors in the prediction of risk of proliferative diabetic retinopathy. N Engl J Med 313: 1433–1438Google Scholar
  7. 7.
    Pirart F (1977) Diabete et complications degeneratives. Presentation d'une etude prospective portant sur 4400 cas observe entre 1947 et 1973. Diabete Metab 3: 97–107, 173–182, 245–256Google Scholar
  8. 8.
    Parving H-H, Oxenbøll B, Svendsen PA, Christiansen JS, Andersen AR (1982) Early detection of patients at risk of developing diabetic nephropathy: a longitudinal study of urinary albumin excretion. Acta Endocrinol 100: 550–555Google Scholar
  9. 9.
    Viberti GC, Hill RD, Jarrett RF, Argyropoulos A, Mahmud U, Keen H (1982) Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet 1: 1430–1432Google Scholar
  10. 10.
    Mathiesen ER, Oxenbøll B, Johansen K, Svendsen PA, Deckert T (1984) Incipient nephropathy in Type 1 (insulin-dependent) diabetes mellitus. Diabetologia 26: 406–410Google Scholar
  11. 11.
    Wiseman M, Viberti GC, Mackintosh D, Jarrett RF, Keen H (1984) Glycemia, arterial pressure and microalbuminuria in Type 1 (insulin-dependent) diabetes mellitus. Diabetologia 26: 401–405Google Scholar
  12. 12.
    Deckert T, Poulsen JE (1981) Diabetic nephropathy: fault or destiny. Diabetologia 21: 178–183Google Scholar
  13. 13.
    Andersen AR, Christiansen JS, Andersen JK, Kreiner S, Deckert T (1983) Diabetic nephropathy in Type 1 (insulin-dependent) diabetes: An epidemiological study. Diabetologia 25: 496–501Google Scholar
  14. 14.
    Borch-Johnsen K, Andersen PK, Deckert T (1985) The effect of proteinuria on relative mortality in Type 1 (insulin-dependent) diabetes mellitus. Diabetologia 28: 590–596Google Scholar
  15. 15.
    Hasslacher C, Stech W, Wahl P, Ritz E (1985) Blood pressure and metabolic control as risk factors for nephropathy in Type 1 (insulin-dependent) diabetes. Diabetologia 28: 6–11Google Scholar
  16. 16.
    Keen H (1984) Normoglycaemic re-entry and diabetic complications. Diabetic Med 1: 85–87Google Scholar
  17. 17.
    Irsigler K, Knitz H, Najemnik C, Freiger H (1979) Reversal of florid diabetic retinopathy. Lancet 2:1068Google Scholar
  18. 18.
    White MC, Kohner EM, Pickup FC, Keen H (1981) Reversal of diabetic retinopathy by continuous subcutaneous insulin infusion: a case report. Br J Ophthalmol 65: 307–314Google Scholar
  19. 19.
    Puklin JE, Tamborlane WV, Felig P, Genel M, Sherwin RS (1982) Influence of long-term insulin infusion pump treatment of type I diabetes on diabetic retinopathy. Ophthalmology 89: 735–747Google Scholar
  20. 20.
    Lawson PM, Champion MC, Canny CLB, Kingsley R, White MC, Dupre J, Kohner EM (1982) Continuous subcutaneous insulin infusion does not prevent progression of proliferative and preproliferative retinopathy. Br J Ophthalmol 66: 762–766Google Scholar
  21. 21.
    Dahl-Jørgensen K, Hanssen KF, Brinchmann-Hansen O (1983) What happens to the retina as diabetic control is tightened? Lancet 1: 652Google Scholar
  22. 22.
    van Ballegooie E, Hooymans JMM, Timmerman Z, Reitsma WD, Sluiter WJ, Schweitzer NMJ, Doorenbos H (1984) Rapid deterioration of diabetic retinopathy during treatment with continuous subcutaneous insulin infusion. Diabetes Care 7: 236–242Google Scholar
  23. 23.
    Friberg TR, Rosenstock F, Sanborn G, Vagheti A, Raskin P (1985) The effect of long-term near normal glycemic control on mild diabetic retinopathy. Ophthalmology 92:1051–1058Google Scholar
  24. 24.
    Barbosa J (1983) Diabetes: The science and the art, hyperglycemia complications. Arch Intern Med 143:1118–1119Google Scholar
  25. 25.
    Lauritzen T, Frost-Larsen K, Larsen HW, Deckert T, The Steno Study Group (1983) Effect of 1 year of near-normal blood glucose levels on retinopathy in insulin-dependent diabetes. Lancet 1: 200–204Google Scholar
  26. 26.
    Lauritzen T, Frost-Larsen K, Larsen H-W, Deckert T, and the Steno Study Group (1985) Two-year experience with continuous subcutaneous insulin infusion in relation to retinopathy and neuropathy. Diabetes 35 (Suppl 3): 74–79Google Scholar
  27. 27.
    Lauritzen T (1985) Pharmacokinetic and clinical aspects of intensified subcutaneous insulin therapy. Dan Med Bull 32,2:104–118Google Scholar
  28. 28.
    Kroc Collaborative Study Group (1985) Blood glucose control and the evolution of diabetic retinopathy and albuminuria. N Engl J Med 311: 365–372Google Scholar
  29. 29.
    Testa MA, Puklin JE, Sherwin RS, Simonson DC (1985) Clinical predictors of retinopathy and its progression in patients with type I diabetes during CSII or conventional insulin treatment. Diabetes 34 (Suppl 3): 61–68Google Scholar
  30. 30.
    Kroc Study Group (1985) Effect of diabetic control on retinopathy. Follow-up report of the Kroc randomized clinical trial. Invest Ophthalmol Vis Sci 26 (Suppl 1): 85Google Scholar
  31. 31.
    Dahl-Jørgensen K, Brinchmann-Hansen O, Hanssen KF, Sandvik L, Aagenaes Ø, Aker Diabetes Group (1985) Rapid tightening of blood glucose control leads to transient deterioration in retinopathy in insulin-dependent diabetes mellitus — The Oslo Study. Br Med J 290: 811–815Google Scholar
  32. 32.
    Dahl-Jørgensen K, Brinchmann-Hansen O, Hanssen KF, Ganes T, Bjoro T, Sandvik L, Aagenæs Ø, Aker Diabetes Group (1986) Near-normoglycemia retards the progression of early diabetic retinopathy and neuropathy. Br Med J (in press)Google Scholar
  33. 33.
    Beck-Nielsen H, Richelsen B, Mogensen CE, Olsen T, Ehlers N, Nielsen CB, Charles P (1985) Effect of insulin pump treatment for one year on renal function and retinal morphology in patients with IDDM. Diabetes Care 8: 585–589Google Scholar
  34. 34.
    Feldt-Rasmussen B, Mathiesen ER, Hegedus L, Deckert T (1986) Kidney function during 12 months of strict metabolic control in insulin-dependent diabetic patients with incipient nephropathy. N Engl J Med 314: 665–670Google Scholar
  35. 35.
    Feldt-Rasmussen B, Mathiesen ER, Deckert T (1986) Effect on the progression of diabetic renal disease during 2 years of strict metabolic control in insulin-dependent diabetes. Diabetes 35: 425 AGoogle Scholar
  36. 36.
    Baudoin C, Maneschi F, Quentil G, Soubrane G, Hayes T, Jones G, Cascas G, Kohner EM (1983) Quantitative evaluation of fluorescein angiograms: Microaneurism counts. Diabetes 32 (Suppl 2): 8–13Google Scholar
  37. 37.
    Harrad RA, Plump AP, Rose GE, Morris RW, Sönksen PH (1984) Two year prospective study of improved control in diabetic patients with background retinopathy. Diabetologia 27: 285 AGoogle Scholar
  38. 38.
    Daneman D, Drash AL, Lobes LA, Becker DF, Baker LM, Travis LB (1981) Progressive retinopathy with improved control in diabetic dwarfism (Mauriac's syndrome). Diabetes Care 4: 360–365Google Scholar
  39. 39.
    Brinchmann-Hansen O, Dahl-Jørgensen K, Hanssen KF, Sandvik L, and Oslo Diabetes Study Group (1985) Effects of intensified insulin treatment on various lesions of diabetic retinopathy. Am J Ophthalmol 100: 644–653Google Scholar
  40. 40.
    Brinchmann-Hansen O, Dahl-Jørgensen K, Hanssen KF, Sandvik L. Diameter of retinal vessels and progression of diabetic retinopathy. Unpublished observationGoogle Scholar
  41. 41.
    Tamborlane WV, Puklin FE, Bergman M, Verdonk C, Rudolf MC, Felig P, Genel M, Sherwin R (1982) Long-term improvement of metabolic control with the insulin pump does not reverse diabetic microangiopathy. Diabetes Care 5 [Suppl 1]: 58–64Google Scholar
  42. 42.
    Koivisto VA, Huttunen N-P, Vierikko P (1981) Continuous subcutaneous insulin infusion corrects exercise-induced albuminuria in juvenile diabetes. Br Med J 282: 778–779Google Scholar
  43. 43.
    Feldt-Rasmussen B, Baker L, Deckert T (1985) Exercise as a provocative test in early renal disease in Type 1 (insulin-dependent) diabetes: Albuminuric, systemic and renal hemodynamic responses. Diabetologia 28: 389–396Google Scholar
  44. 44.
    Parving H-H, Noer I, Deckert T, Errin P-E, Nielsen SL, Lyngsøe J, Mogensen CE, Rorth M, Svendsen PA, Trap-Jensen J, Lassen NA (1976) The effect of metabolic regulation on microvasular permability to small and larbe molecules in short term juvenile diabetics. Diabetologia 12: 161–166Google Scholar
  45. 45.
    Viberti GC, Bilous RW, Mackintosh D, Bending JJ, Keen H (1983) Long-term correction of hyperglycaemia and progression of renal failure in insulin-dependent diabetes. Br Med J 286: 598–601Google Scholar
  46. 46.
    Viberti GC, Pickup FC, Jarrett RF, Keen H (1979) Effect of control of blood glucose on urinary excretion of albumin and B2-micro-globulin in insulin-dependent diabetes. N Engl J Med 300: 638–641Google Scholar
  47. 47.
    Gavarella A, Vannini P, Flammini M, Bacci L, Forlani G, Borgnino (1985) Effect of long-term near-normoglycemia on the progression of nephropathy. Diabete Metab 77: 3–8Google Scholar
  48. 48.
    Bending JJ, Viberti GC, Watkins PJ, Keen H (1986) Intermittent clinical proteinuria and renal function in diabetes: evolution and the effect of glycaemic control. Br Med J 292: 83–86Google Scholar
  49. 49.
    Deckert T, Lauritzen T, Parving H-H, Christiansen JS, The Steno Study Group (1984) Effect of two years of strict metabolic control on kidney function in long-term insulin-dependent diabetes. Diab Nephrop 3: 6–10Google Scholar
  50. 50.
    Feldt-Rasmussen B, Mathiesen ER (1984) Variability of urinary albumin excretion in incipient diabetic nephropathy. Diab Nephrop 3: 101–103Google Scholar
  51. 51.
    Feldt-Rasmussen B, Mogensen CE, Christiansen CK, Mathiesen ER, Deckert T (1984) Blood glucose control and diabetic microangiopathy. N Engl J Med 311: 1577–1528Google Scholar
  52. 52.
    Dyck PJ, Karnes JL, Daube J, O'Brien P, Service FJ (1985) Clinical and neuropathological criteria for the diagnosis and staging of diabetic polyneuropathy. Brain 708: 861–880Google Scholar
  53. 53.
    Sima AAF, Brismar T (1985) Reversible diabetic nerve dysfunction: Structural correlates to electrophysiological abnormalities. Ann Neurol 18: 21–29Google Scholar
  54. 54.
    Sima AAF, Lattimer SA, Yagihashi S, Greene DA (1986) Axo-glial dysjunction. A novel structural lesion that accounts for poorly reversible slowing of nerve conduction in the spontaneously diabetic bio-breeding rat. J Clin Invest 77: 474–484Google Scholar
  55. 55.
    Gregersen G (1967) Diabetic neuropathy: Influence of age, sex, metabolic control and duration of diabetes on motor nerve conduction velocity. Neurology (NY) 17: 972–980Google Scholar
  56. 56.
    Ward JD, Barnes CG, Fisher DJ, Jessup JD, Baker RWR (1971) Improvement in nerve conduction following treatment in newly diagnosed diabetes. Lancet 1: 428–430Google Scholar
  57. 57.
    Graf RJ, Halter JB, Pfeifer MA, Harlan E, Brozovich BSE, Porte D (1981) Glycemic control and nerve conduction abnormalities in noninsulin dependent diabetic subjects. Ann Intern Med 94: 307–311Google Scholar
  58. 58.
    Boulton AJM, Worth RC, Drury J, Hardisty CA, Wolf E, Cudworth AG, Ward JD (1984) Genetic and metabolic studies in diabetic neuropathy. Diabetologia 26:15–19Google Scholar
  59. 59.
    Boulton AJM, Drury J, Clark B, Ward JD (1982) Continuous subcutaneous insulin infusion in the management of painful diabetic neuropathy. Diabetes Care 5: 386–390Google Scholar
  60. 60.
    Pietri A, Ehle AL, Raskin P (1980) Changes in nerve conduction velocity after six weeks of glucoregulation with portable insulin infusion pumps. Diabetes 29: 668–671Google Scholar
  61. 61.
    Gambardelia S, Napoli A, Spallone V, Verrastsro AM, Lazzan R, Geraldine C, Sideri G, Manzinger G (1983) Influence of glucoregulation with continuous subcutaneous insulin infusion on nerve conduction velocity and beat to beat variation in diabetes. J Endocrinol Invest 6: 363–369Google Scholar
  62. 62.
    Service FJ, Rizz RA, Daube JR, O'Brien PC, Dyck PJ (1985) Near normoglycemia improved nerve conduction and vibration sensation in diabetic neuropathy. Diabetologia 28: 722–727Google Scholar
  63. 63.
    Jaspan J, Maselli R, Herold K, Bartkus C (1983) Treatment of severe painful neuropathy with an aldose reductase inhibitor: Relief of pain and improved somatic and autonomic nerve function. Lancet 2:758–762Google Scholar
  64. 64.
    Barbosa J (1984) Do genetic factors play a role in the pathogenesis of diabetic microangiopathy. Diabetologia 27: 487–492Google Scholar
  65. 65.
    Assal JP, Berger M, Gay N, Canivet J (eds) (1983) Diabetes education: how to improve patient education, ICS No 624. Excerpta Medica, AmsterdamGoogle Scholar
  66. 66.
    Tattersall RB, McCulloch DK, Aveline M (1985) Group therapy in the treatment of diabetes. Diabetes Care 8: 180–188Google Scholar
  67. 67.
    Unger RH (1982) Meticulous control of diabetes: Benefits, risks and precautions. Diabetes 31: 479–483Google Scholar
  68. 68.
    Thorsteinsson B, Pramming S, Lauritzen T, Binder C (1986) Frequency of daytime biochemical hypoglycaemia in insulin-treated diabetic patients: relation to daily median blood glucose concentrations. Diabetic Med 3: 147–151Google Scholar

Copyright information

© Springer-Verlag 1986

Authors and Affiliations

  • K. F. Hanssen
    • 1
    • 4
  • K. Dahl-Jørgensen
    • 2
    • 3
    • 4
  • T. Lauritzen
    • 6
  • B. Feldt-Rasmussen
    • 6
  • O. Brinchmann-Hansen
    • 5
  • T. Deckert
    • 6
  1. 1.Diabetic Unit Aker SykehusOslo 5Norway
  2. 2.Department of PediatricsDiabetes/Endocrine SectionDenmark
  3. 3.Department of Clinical ChemistryDiabetes/Endocrine SectionDenmark
  4. 4.Diabetic Unit Aker SykehusOslo 5Norway
  5. 5.Eye DepartmentUlleval University HospitalOsloNorway
  6. 6.Steno Memorial HospitalGentofteDenmark

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