Abstract
Clinical features of mild type II diabetes mellitus complicated by proliferative retinopathy were compared to those without proliferative retinopathy. One hundred and twenty-two mild type II diabetics who were under good control with diet alone were divided into three groups according to the severity of their retinopathy: those without retinopathy (group 1, 63 patients), those with simple retinopathy (group 2, 47 patients) and those with proliferative retinopathy (group 3, 12 patients). Patients with proliferative retinopathy were found to have a significantly long history of diabetes and significantly heavy maximal body weight index in the past compared to the other two groups. Since it has already been established that the severity of diabetic retinopathy is correlated with the duration of diabetes, various clinical aspects were compared between 12 diabetics suffering from proliferative retinopathy (group 3) and 14 diabetics without retinopathy who were selected from group 1 by matching not only their age and sex, but also the duration of diabetes to their counterparts in goup 3, and the following results were obtained.
1) Patients with proliferative retinopathy and a longer untreated period for their diabetes and heavier maximal body weight index in the past than those without retinopathy.
2) In 10 out of the 12 diabetic patients with proliferative retinopathy, the condition had already developed before the initiation of treatment for diabetes.
3) Although both glucose tolerance and plasma insulin response to 50 g oral glucose had been significantly impaired in patients with proliferative retinopathy compared to those without retinopathy before the start of the treatment for diabetes, the impaired glucose tolerance and decreased insulin response in patients with proliferative retinopathy improved significantly, and there were no significant differences of glucose tolerance and insulin responses to 75 g oral glucose between patients with and without retinopathy after the good control had been obtained by diet therapy alone.
4) Hypertension more frequently complicated patients with proliferative retinopathy than those without.
Thus, it should be emphasized that even mild type II diabetics have the possibility of developing proliferative retinopathy when they have a long untreated period of diabetes with high blood glucose and increased body weight.
