Diabetic Retinopathy in Japanese Patients with Long-Standing Pancreatic Diabetes Due to Calcifying Pancreatitis.

Abstract

This study analyzed the prevalence, aggravating factors (including duration of diabetes, glycemic control, body mass index, hypertension, serum total cholesterol, changes of ST on ECG and diabetic therapies) and characteristics of diabetic retinopathy in 75 patients with pancreatic diabetes resulting from calcifying pancreatitis. The patients were divided into three Groups: Group I (27 patients in whom diabetes was detected earlier than pancreatic stones), Group II (36 patients in whom diabetes and pancreatic stones were simultaneously detected) and Group III (12 patients in whom pancreatic stones were detected earlier than diabetes). The prevalence of retinopathy was dependent on the duration of diabetes as well as poor glycemic control. It was significantly (p <0.01) higher among the patient with the duration of diabetes that was more than 5 years than that of the patients whose duration was less than 5 years. The prevalence of retinopathy in Group I (63%) was significantly (p <0.05) higher than that in Group 11 (30.6%) and Group III (12.5%). Proliferative retinopathy was not found in any patients with a duration of diabetes less than 5 years, while it was found in 5 patients with a duration of more than 5 years (5 cases out of 31 patients). Diabetic retinopathy was correlated with the duration of diabetes and glycemic control, and was not linked to frequency of hypoglycemia and family history of diabetes. From the results above, we concluded that diabetic retinopathy in patients with pancreatic diabetes due to calcifying pancreatitis might be taken as evidence that such complications are primarily due to chronic hyperglycemia and the duration of diabetes mellitus rather than to genetic factors and other factors (body mass index, hypertension, serum total cholesterol and diabetic therapies). diabetic retinopathy; pancreatic diabetes; duration of diabetes; chronic hyperglycemia; calcifying pancreatitisIn the past, the prevalence of complication by diabetic retinopathy in patients with pancreatic diabetes was thought to be low (Sevel et al. 1971). However, after Sprague reported the complication of pancreatic diabetes (microangiopathy) in 1947 (Sprague 1947), microangiopathy in patients with pancreatic

Screening attendance, prevalence and severity of diabetic retinopathy (DR) in a cohort of patients with diabetes mellitus secondary to chronic pancreatitis (DMsCP) in Northern Ireland

“…There are limited data on DR rates and severity in PwDMsCP. Estimates range from 7.4% to 63%, [5][6][7][8][9][10][11] with duration of diabetes, severity of pancreatitis and poor glycemic control being the main contributors. The only prospective study to date included 54 patients with chronic pancreatitis or pancreatectomy, and assessed DR presence and severity using fluorescein angiogram and ophthalmoscopic examination, 9 with 31% having background DR, none PDR.…”

Clinical assessment of pancreatic diabetes caused by chronic pancreatitis

“…18,19 Diabetic angiopathy seems to result from poor glycemic control. 20,21 Pancreatic diabetes is often poorly controlled, as insufficient insulin may be administered because of the risk of frequent hypoglycemic episodes; oxyhyperglycemia may occur after gastric surgery (often performed for accompanying peptic ulcer or gastric cancer) ( Table 1); and the patient may exhibit alcohol abuse. 10 Self-monitoring of blood glucose and intensive insulin therapy should be considered to improve glycemic control.…”