Abstract
To evaluate methods of blood glucose control affecting the retinopathy of NIDDM patients without Achilles'tendon reflex (ATR), in those cases with a high incidence of retinopathy deterioratation when rapid blood glucose control (RBC) was performed, 84 patients were studied. All subjects were hospitalized for 2-4 weeks for a checkup. FBG was measured every day and followed up for one year. HbA1c was measured every 3 months. A retinal examination was performed on admission and again after one year. Deterioration in retinopathy was defined as either a progressionof NDR to SDR, or of preproliferative retinopathy (PPDR) and SDR to PPDR.
The rate of change of HbAic after 3 months and of FBG after 2 weeks was employed in the index of blood glucose control. Mean HbAic of one year was defined as mean HbA1c 3 months after admission. The retinopathy condition deteriorated in 27cases. The rate of change of HbA1c after 3 months (RCH) and of FBG after 2 weeks (RCF) was correlated significantly (r=0.71p<0.0001), and retinopathy deteriorated significantly more when RCH and RCF was more than 30%.The rate of deterioration in retinopathy was highest (77%) when RCH was more than 30% and mean HbAic was above 8%, and deterio ration was lowest (7%) when RCH was less than 30% and mean HbAic was below 8%. These results indicate that blood glucose control in admission must be handled conservatively and mean HbA1c of one year must be below 8% in NIDDM patients without ATR.
