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Bilateral diabetic papillopathy and metabolic control
Christoffer Ostri1, Henrik Lund-Andersen, Birgit Sander
1Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark. oejenforsk@glo.regionh.dk
Ophthalmology
|June 19, 2010
Summary
Diabetic papillopathy may occur in patients with type 1 diabetes who have a small optic disc and experience a rapid decrease in blood sugar levels. This finding suggests a potential early complication linked to improved glycemic control.
Area of Science:
- Ophthalmology
- Endocrinology
- Diabetology
Background:
- The exact cause of diabetic papillopathy remains unclear.
- Previous reports suggest a link between this condition and rapid improvements in metabolic control.
Purpose of the Study:
- To investigate the hypothesis that diabetic papillopathy may be associated with a recent, drastic reduction in glycemia.
Main Methods:
- A retrospective case-control study involving 2,066 patients with type 1 diabetes.
- Analysis of clinical, photographic, and clinical chemistry records from 2001 to 2008.
- Focus on identifying cases of simultaneous, bilateral diabetic papillopathy.
Main Results:
- Bilateral diabetic papillopathy developed in 5 patients over 10,020 patient-years.
- These patients showed a significant decrease in glycosylated hemoglobin A1c (HbA1c) in the preceding year (mean rate of -2.5 percentage points/quarter).
- Pre-incident photographs revealed small cup-to-disc ratios in all affected patients.
Conclusions:
- Diabetic papillopathy is strongly associated with a rapid recent decrease in blood glucose levels and a small cup-to-disc diameter.
- This supports the hypothesis that diabetic papillopathy may represent an early complication in anatomically predisposed individuals due to swift glycemic reduction.
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