Effect of intensive insulin therapy on macular biometrics, plasma VEGF and its soluble receptor in newly diagnosed diabetic patients

Hernández, Cristina; Zapata, Miguel Á.; Losada, Eladio; Villarroel, Marta; Garcia-Ramírez, Marta; García‐Arumí, José; Simó, Rafael

doi:10.1002/dmrr.1093

Cited by 11 publications

(7 citation statements)

References 27 publications

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“…VEGF expression was linked to vascular permeability . In addition, a study of 26 patients newly diagnosed with type 1 or type 2 diabetes showed that, in those who experienced blurred vision after initiating insulin therapy, a transient increase in macular volume and thickness followed, which is associated with a decrease in the circulating soluble VEGF receptor, sFlt‐1 (Table ) …”

Section: Theories Concerning the Paradoxical Early Worsening Of Drmentioning

confidence: 99%

Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review

Bain

Klufas

et al. 2018

Diabetes Obesity Metabolism

154

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Worsening of diabetic retinopathy (DR) is associated with the initiation of effective treatment of glycaemia in some patients with diabetes. It has been associated with risk factors such as poor blood-glucose control and hypertension, and it manifests prior to the long-term benefits of optimizing glycaemic control. The majority of evidence supports an association of large and rapid reductions in blood-glucose levels with early worsening of DR. Despite a general awareness of early worsening within the diabetes community, mechanisms to explain the phenomenon remain speculative. We provide an overview of early worsening of DR and its pathophysiology based on current data. We describe the phenomenon in various settings, including in patients receiving insulin- or non-insulin-based treatments, in those undergoing bariatric surgery, and in pregnant women. We discuss various mechanisms and theories that have been suggested to explain this paradoxical phenomenon, and we summarize the implications of these in clinical practice.

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Section: Theories Concerning the Paradoxical Early Worsening Of Drmentioning

confidence: 99%

Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review

Bain

Klufas

et al. 2018

Diabetes Obesity Metabolism

154

View full text Add to dashboard Cite

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“…Poulaki et al (20) demonstrated that acute intensive insulin therapy produced a transient worsening of diabetic BRB breakdown via an HIF-1a-mediated increase in retinal VEGF expression. Finally, Hernández et al (21) provided evidence that diabetic patients with blurred vision after starting insulin therapy present a significant transient increase of macular biometrics (volume and thickness) that is associated with a Figure 2-Main mechanisms involved in VEGF upregulation and its consequences in the pathogenesis of diabetic retinopathy. Hypoxia is the most important trigger for VEGF upregulation mainly through HIF-1.…”

Section: Mechanisms Regulating Vegf Expressionmentioning

confidence: 99%

Ocular Anti-VEGF Therapy for Diabetic Retinopathy: The Role of VEGF in the Pathogenesis of Diabetic Retinopathy

2014

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Diabetic retinopathy is the leading cause of visual impairment and preventable blindness, and represents a significant socioeconomic cost for health care systems worldwide. Therefore, new approaches beyond current standards of diabetes care are needed. Based on the crucial pathogenic role of vascular endothelial growth factor (VEGF) in the development of diabetic macular edema (DME), intravitreal anti-VEGF agents have emerged as new treatments. To provide an understanding of the rationale for use and clinical efficacy of anti-VEGF treatment, we examine this topic in a two-part Bench to Clinic narrative. In the Bench narrative, we provide an overview of the role of VEGF in the pathogenesis of diabetic retinopathy, the molecular characteristics of anti-VEGF agents currently used, and future perspectives and challenges in this area. In the Clinic narrative that follows our contribution, Cheung et al. provide an overview of the current evidence from clinical trials on anti-VEGF therapy for diabetic retinopathy.

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“…Here we report an open-controlled trial to evaluate the long-term effects of implantation of autologous bone marrow mononuclear cells for type 2 diabetes mellitus (T2DM). We first used autologous mononuclear cells from bone marrow to treat patients with T2DM in March 2007, and patients treated with insulin intensification therapy [4] were included as controls to assess whether the effect of mononuclear cells from bone marrow on DM was dependent on concomitant insulin and drug therapy. All patients were followed up for 3 years to evaluate the safety and long-term effects of the therapy.…”

Section: Stem Cell Harvesting and Implantationmentioning

confidence: 99%

Long term effects of the implantation of autologous bone marrow mononuclear cells for type 2 diabetes mellitus

Wang

et al. 2012

Endocr J

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Effect of intensive insulin therapy on macular biometrics, plasma VEGF and its soluble receptor in newly diagnosed diabetic patients

Abstract: Diabetic patients with blurred vision after starting insulin therapy present a significant transient increase in macular biometrics which is associated with a decrease in circulating sFlt-1.

Cited by 11 publications

References 27 publications

Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review

Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review

Ocular Anti-VEGF Therapy for Diabetic Retinopathy: The Role of VEGF in the Pathogenesis of Diabetic Retinopathy

Long term effects of the implantation of autologous bone marrow mononuclear cells for type 2 diabetes mellitus

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