The response of diabetic retinopathy to 41 months of multiple insulin injections, insulin pumps, and conventional insulin therapy

Arch Ophthalmol. 1988 Sep;106(9):1242-6. doi: 10.1001/archopht.1988.01060140402041.


Forty-five diabetic patients were randomized and treated with continuous subcutaneous insulin infusion (CSII), multiple insulin injections (MI), or conventional insulin treatment (CIT) for 41 months. Near-normoglycemia was obtained with CSII and MI but not with CIT. A transient increase in microaneurysms and hemorrhages was seen at three months in CSII-treated patients. After 41 months, a moderate progression in microaneurysms and hemorrhages was registered, as assessed from fundus photographs, in all treatment groups. Fluorescein angiograms indicated a tendency (not statistically significant) to retarded progression of retinopathy in MI- and CSII-treated patients compared with CIT-treated patients. Soft exudates developed after three to six months of rapid tightening of metabolic control in 50% of patients on CSII and MI regimens. Those patients who had soft exudates had a slower progression of retinopathy three years later than those who did not develop soft exudates. Transient progression of retinopathy may be related to fluctuations in blood glucose levels, although a favorable effect of long-term improved metabolic control was not documented.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aneurysm / pathology
  • Blood Glucose / analysis
  • Clinical Trials as Topic
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / pathology
  • Exudates and Transudates / metabolism
  • Fluorescein Angiography
  • Hemoglobin A / analysis
  • Humans
  • Injections
  • Insulin / therapeutic use*
  • Insulin Infusion Systems
  • Retinal Hemorrhage / pathology
  • Retinal Vessels / metabolism
  • Time Factors


  • Blood Glucose
  • Insulin
  • Hemoglobin A