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Transplantation. 2008 May 27;85(10):1400-5. doi: 10.1097/TP.0b013e318172ca07.

Reduced progression of diabetic retinopathy after islet cell transplantation compared with intensive medical therapy.

Author information

  • 1Department of Medicine, University of British Columbia, Vancouver, BC, Canada. david.thompson@vch.ca

Abstract

BACKGROUND:

Diabetic retinopathy is a major complication of type 1 diabetes and remains a leading cause of visual loss. There have been no comparisons of the effectiveness of intensive medical therapy and islet cell transplantation on preventing progression of diabetic retinopathy.

METHODS:

The British Columbia islet transplant program is conducting a prospective, crossover study comparing medical therapy and islet cell transplantation on the progression of diabetic retinopathy. Progression was defined as the need for laser treatment or a one step worsening along the international disease severity scale. An interim data analysis was performed after a mean 36-month follow-up postislet transplantation and these results are presented.

RESULTS:

The medical and postislet transplant groups were similar at baseline. Subjects after islet transplantation had better glucose control than the medically treated subjects (mean HbA1c 6.7%+/-0.9% vs. 7.5+/-1.2, P<0.01) and were C-peptide positive. Progression occurred significantly more often in all subjects in the medical group (10/82 eyes, 12.2%) than after islet transplantation (0/51 eyes, 0%) (P<0.01). Considering only subjects who have received transplants, progression occurred in 6/51 eyes while on medical treatment and 0/51 posttransplant (P<0.02).

CONCLUSIONS:

Progression of diabetic retinopathy was more likely to occur during medical therapy than after islet cell transplantation.

PMID:
18497678
[PubMed - indexed for MEDLINE]
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