Rapidly progressing diabetic retinopathy upon improved metabolic control

Elevation of serum IGF-1 precedes proliferative diabetic retinopathy in Mauriac's syndrome

“…3 IGF-1, which has growth promoting and angiogenic effects, was shown to increase after inducing improved glycaemic control, and this surge in serum IGF-1 concentration preceded retinal neovascularisation by 2 months. Exogenous IGF-1 can have serious side effects on the retinal circulation and can cause ‘papillopathy’, as has been described by Gallagher et al ,4 and others 5…”

Elevation of Serum IGF-1 Rather than Sex Steroids Precedes Prolif erative Diabetic Retinopathy in Mauriac’s Syndrome

“…Hypoglycemia or changes in blood flow [7] have been con sidered to explain retinal deterioration following an abrupt and substantial improvement in blood glucose (socalled 'normoglycemic re-entry') [10][11][12], The potential effects of sexual hormones have also received attention [8,13], since puberty aggravates retinopathy in man, castra tion prevents diabetic microangiopathy in animals [8], and gonadal dysgenesis is associated with a lack of long term diabetic complications in man [14]. Despite low sex hormone concentrations, retinal pathology progressed in our study confirming previous suggestions that sex ste roids are not directly causative of diabetic retinopathy [13,15], According to other hypotheses, GH and IGF-1 may accelerate diabetic retinopathy [16,17].…”