Capillary Loss and Leakage after Five Years of Intensified Insulin Treatment in Patients with Insulin-dependent Diabetes Mellitus

Abstract

Ninety-six patients with insulin-dependent diabetes mellitus were randomized to intensified conventional treatment (n=44) or regular treatment (n=52) programs and followed for 5 years. Hemoglobin A1c was reduced from 9.5% ± 0.1 % to 7.2% ± 0.1 % in the intensified conventional treatment group and from 9.4% ± 0.2% to 8.7% ± 0.1 % in the regular treatment group (mean + standard error) (P < 0.001). Capillary loss and leakage of fluorescein as evaluated with fluorescein angiography increased significantly in the regular treatment group (P < 0.05; P < 0.01) but not in the intensified conventional treatment group. Capillary loss (P < 0.01) and leakage (P < 0.001) were related to metabolic control as measured by Hb A1c but not to duration of diabetes or smoking habits. Capillary loss (P < 0.05) but not leakage was related to the initial diastolic blood pressure.