Abstract
The effectiveness of CSII in IDDM patients was evaluated in terms of preventing diabeticcomplications, especially diabetic retinopathy, and clinical safety. Twenty IDDM patients (age: 31±10 years, mean±SD;sex [M/F]: 11/9;duration of IDDM: 5.7±5.1 years) were treated withCSII for 6.9±5.0 (1.5-15) years.
The values of HbA1c and fasting blood glucose (FBG) in these patients decreased significantlyafter initiation of CSII. Body weights of the IDDM patients increased and reached the maximallevels at 11 years (mean BMI 22.2kg/m2). The frequency of hypoglycemia increasted to 3-5 timeshigher than that in the pre-CSII period. However, life-threatening hypoglycemia did not occurrduring CSII. Diabetic retinopathy developed in 2 of the patients: in one patient simple retinopathydeveloped 1 year after initiation of CSII and had progressed to the preproliferative stage 4 yearslater. Simple retinopathy in the other patient progressed to the preproliferative stage 0.3 years afterCSII. Simple retinopthy disappeared in one patient 8 years after CSII. Overall frequencies ofdevelopment to simple diabetic retinopathy and progression to proliferative retinopathy in the 20patients treated with CSII was significantly lower than that in IDDM patients treated with non-CSII therapy.
Long-term treatment with CSII in IDDM patients is a safe and effective insulin regimen formaintaining near-normoglycemia and preventing the development and progression of diabeticretinopathy.
