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Diabetology & Metabolic Syndrome
Published in: Diabetology & Metabolic Syndrome 1/2009

Open Access 01-12-2009 | Case report

Absence of diabetic retinopathy in a patient who has had diabetes mellitus for 69 years, and inadequate glycemic control: case presentation

Authors: Jorge Esteves, Carolina Maurente da Rosa, Caroline Kaercher Kramer, Luiz Eduardo Osowski, Stéfano Milano, Luís Henrique Canani

Published in: Diabetology & Metabolic Syndrome | Issue 1/2009

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Abstract

The main risk factors for the development and progression of diabetic retinopathy (DR) are chronic hyperglycemia, disease duration and systemic blood pressure. So far chronic hyperglycemia is the strongest evidence concerning the risk of developing DR. However there are some patients with poor metabolic control who never develop this diabetic complication. We present a case of a 73-year-old woman with type 1 diabetes mellitus, diagnosed 69 years ago. The patient is 73 years old, with no evidence of DR, despite poor glycemic control and several risk factors for DR. This case suggests the presence of a possible protection factor, which could be genetic.
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Literature
1.
Boelter MCAM, Gross JL, Lavinsky J: Fatores de risco para retinopatia diabética. Arq Bras Oftalmol. 2003, 66: 239-247. 10.1590/S0004-27492003000200024.CrossRef
2.
Esteves J, Laranjeira AF, Roggia MF, Dalpizol M, Scocco C, Kramer CK, Azevedo MJ, Canani LH: [Diabetic retinopathy risk factors]. Arq Bras Endocrinol Metabol. 2008, 52: 431-441.CrossRefPubMed
3.
The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993, 329: 977-986. 10.1056/NEJM199309303291401.
4.
The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial. Arch Ophthalmol. 1995, 113: 36-51.
5.
Leitao CB, Canani LH, Kramer CK, Moehlecke M, Pinto LC, Ricardo ED, Pinotti AF, Gross JL: Blood pressure means rather than nocturnal dipping pattern are related to complications in Type 2 diabetic patients. Diabet Med. 2008, 25: 308-313. 10.1111/j.1464-5491.2007.02354.x.CrossRefPubMed
6.
Leitao CB, Canani LH, Kramer CK, Boza JC, Pinotti AF, Gross JL: Masked hypertension, urinary albumin excretion rate, and echocardiographic parameters in putatively normotensive type 2 diabetic patients. Diabetes Care. 2007, 30: 1255-1260. 10.2337/dc06-2131.CrossRefPubMed
7.
Kramer CK, Leitao CB, Azevedo MJ, Valiatti FB, Rodrigues TC, Canani LH, Gross JL: Diabetic retinopathy is associated with early autonomic dysfunction assessed by exercise-related heart rate changes. Braz J Med Biol Res. 2008, 41: 1110-1115. 10.1590/S0100-879X2008001200011.CrossRefPubMed
8.
Kramer CK, Leitao CB, Canani LH, Gross JL: Impact of white-coat hypertension on microvascular complications in type 2 diabetes. Diabetes Care. 2008, 31: 2233-2237. 10.2337/dc08-1299.PubMedCentralCrossRefPubMed
9.
Kramer CK, Leitao CB, Canani LH, Ricardo ED, Pinto LC, Valiatti FB, Gross JL: Late afternoon blood pressure increase is associated with diabetic retinopathy in normotensive type 2 diabetes mellitus patients. Diabetes Res Clin Pract. 2009, 84: e12-14. 10.1016/j.diabres.2008.12.016.CrossRefPubMed
10.
van Leiden HA, Dekker JM, Moll AC, Nijpels G, Heine RJ, Bouter LM, Stehouwer CD, Polak BC: Risk factors for incident retinopathy in a diabetic and nondiabetic population: the Hoorn study. Arch Ophthalmol. 2003, 121: 245-251.CrossRefPubMed
11.
Pambianco G, Costacou T, Ellis D, Becker DJ, Klein R, Orchard TJ: The 30-year natural history of type 1 diabetes complications: the Pittsburgh Epidemiology of Diabetes Complications Study experience. Diabetes. 2006, 55: 1463-1469. 10.2337/db05-1423.CrossRefPubMed
12.
Stratton IM, Kohner EM, Aldington SJ, Turner RC, Holman RR, Manley SE, Matthews DR: UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia. 2001, 44: 156-163. 10.1007/s001250051594.CrossRefPubMed
13.
Vitale S: The Wisconsin Epidemiologic Study of Diabetic Retinopathy: what can we learn at 14 years?. Ophthalmology. 1998, 105: 1799-1800. 10.1016/S0161-6420(98)91019-3.CrossRefPubMed
14.
Krolewski AS, Warram JH, Rand LI, Christlieb AR, Busick EJ, Kahn CR: Risk of proliferative diabetic retinopathy in juvenile-onset type I diabetes: a 40-yr follow-up study. Diabetes Care. 1986, 9: 443-452. 10.2337/diacare.9.5.443.CrossRefPubMed
15.
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998, 352: 837-853. 10.1016/S0140-6736(98)07019-6.
16.
Henricsson M, Nystrom L, Blohme G, Ostman J, Kullberg C, Svensson M, Scholin A, Arnqvist HJ, Bjork E, Bolinder J, Eriksson JW, Sundkvist G: The incidence of retinopathy 10 years after diagnosis in young adult people with diabetes: results from the nationwide population-based Diabetes Incidence Study in Sweden (DISS). Diabetes Care. 2003, 26: 349-354. 10.2337/diacare.26.2.349.CrossRefPubMed
17.
Janka HU, Warram JH, Rand LI, Krolewski AS: Risk factors for progression of background retinopathy in long-standing IDDM. Diabetes. 1989, 38: 460-464. 10.2337/diabetes.38.4.460.CrossRefPubMed
18.
Klein R, Klein BE, Moss SE, Davis MD, DeMets DL: The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol. 1984, 102: 520-526.CrossRefPubMed
19.
Klein R, Klein BE, Moss SE, Davis MD, DeMets DL: The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol. 1984, 102: 527-532.CrossRefPubMed
20.
Harvey JN, Allagoa B: The long-term renal and retinal outcome of childhood-onset Type 1 diabetes. Diabet Med. 2004, 21: 26-31. 10.1046/j.1464-5491.2003.01062.x.CrossRefPubMed
21.
Porta M, Sjoelie AK, Chaturvedi N, Stevens L, Rottiers R, Veglio M, Fuller JH: Risk factors for progression to proliferative diabetic retinopathy in the EURODIAB Prospective Complications Study. Diabetologia. 2001, 44: 2203-2209. 10.1007/s001250100030.CrossRefPubMed
22.
Klein R, Klein BE, Moss SE, Davis MD, DeMets DL: Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. Jama. 1988, 260: 2864-2871. 10.1001/jama.260.19.2864.CrossRefPubMed
23.
Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998, 352: 854-865. 10.1016/S0140-6736(98)07037-8.
24.
Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. Bmj. 1998, 317: 703-713.
25.
Gerchman F, Zanatta CM, Burttet LM, Picon PX, Lisboa HR, Silveiro SP, Gross JL, Canani LH: Vascular complications of black patients with type 2 diabetes mellitus in Southern Brazil. Braz J Med Biol Res. 2008, 41: 668-673.CrossRefPubMed
26.
Imperatore G, Hanson RL, Pettitt DJ, Kobes S, Bennett PH, Knowler WC: Sib-pair linkage analysis for susceptibility genes for microvascular complications among Pima Indians with type 2 diabetes. Pima Diabetes Genes Group. Diabetes. 1998, 47: 821-830. 10.2337/diabetes.47.5.821.CrossRefPubMed
27.
Hallman DM, Boerwinkle E, Gonzalez VH, Klein BE, Klein R, Hanis CL: A genome-wide linkage scan for diabetic retinopathy susceptibility genes in Mexican Americans with type 2 diabetes from Starr County, Texas. Diabetes. 2007, 56: 1167-1173. 10.2337/db06-1373.CrossRefPubMed
28.
Felinski EA, Antonetti DA: Glucocorticoid regulation of endothelial cell tight junction gene expression: novel treatments for diabetic retinopathy. Curr Eye Res. 2005, 30: 949-957. 10.1080/02713680500263598.CrossRefPubMed
29.
dos Santos KG, Canani LH, Gross JL, Tschiedel B, Souto KE, Roisenberg I: The catalase -262C/T promoter polymorphism and diabetic complications in Caucasians with type 2 diabetes. Dis Markers. 2006, 22: 355-359.PubMedCentralCrossRefPubMed
30.
dos Santos KG, Canani LH, Gross JL, Tschiedel B, Souto KE, Roisenberg I: The -106CC genotype of the aldose reductase gene is associated with an increased risk of proliferative diabetic retinopathy in Caucasian-Brazilians with type 2 diabetes. Mol Genet Metab. 2006, 88: 280-284. 10.1016/j.ymgme.2006.02.002.CrossRefPubMed
31.
Errera FI, Canani LH, Silva ME, Yeh E, Takahashi W, Santos KG, Souto KE, Tschiedel B, Roisenberg I, Gross JL, Passos-Bueno MR: Functional vascular endothelial growth factor -634G>C SHP is associated with proliferative diabetic retinopathy: a case-control study in a Brazilian population of European ancestry. Diabetes Care. 2007, 30: 275-279. 10.2337/dc06-1399.CrossRefPubMed
Metadata
Title
Absence of diabetic retinopathy in a patient who has had diabetes mellitus for 69 years, and inadequate glycemic control: case presentation
Authors
Jorge Esteves
Carolina Maurente da Rosa
Caroline Kaercher Kramer
Luiz Eduardo Osowski
Stéfano Milano
Luís Henrique Canani
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Diabetology & Metabolic Syndrome / Issue 1/2009
Electronic ISSN: 1758-5996
DOI
https://doi.org/10.1186/1758-5996-1-13

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