Dynamic changes in retinal vessel diameter during acute hyperglycemia in type 1 diabetes

J Diabetes Complications. 2018 Feb;32(2):234-239. doi: 10.1016/j.jdiacomp.2017.10.001. Epub 2017 Oct 24.

Abstract

Aims: To investigate changes in retinal vessel diameter during acute hyperglycemia in patients with type 1 diabetes.

Methods: We conducted a study on 11 subjects with type 1 diabetes. Euglycemia was maintained for 3h followed by induction of hyperglycemia and simultaneous bolus of rapid acting insulin. Two fundus photos were captured during euglycemia and five fundus photos, blood glucose and blood pressure were taken every 30min for 2.5h post-prandial. Central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) were measured over the study visit and examined using generalized linear mixed models.

Results: In a multivariate mixed model, mean CRAE and CRVE were reduced at 90min post-prandial in both zones B and C. In repeated measures analysis, arterioles exhibited a significant association with change in vessel caliber per change in blood glucose. Inconsistent effects of blood pressure on vessel diameter were also measured.

Conclusions: We document a change in retinal vessel diameter during acute hyperglycemia in persons with type 1 diabetes. Larger controlled studies are required to further investigate this phenomenon and to more accurately assess if hyperglycemia has direct effects on retinal vessel diameter.

Keywords: Autoregulation; Complications; Hyperglycemia; Retinal vascular imaging; Retinopathy.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Blood Pressure / drug effects
  • Blood Pressure / physiology
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / pathology*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / etiology
  • Diabetic Retinopathy / pathology*
  • Diabetic Retinopathy / physiopathology
  • Female
  • Fundus Oculi
  • Glucose / administration & dosage
  • Glucose / pharmacology
  • Humans
  • Hyperglycemia / chemically induced
  • Hyperglycemia / etiology
  • Hyperglycemia / pathology*
  • Insulin / administration & dosage
  • Insulin / pharmacology
  • Male
  • Middle Aged
  • Organ Size
  • Photography
  • Pilot Projects
  • Retinal Artery / diagnostic imaging
  • Retinal Artery / pathology
  • Retinal Vein / diagnostic imaging
  • Retinal Vein / pathology
  • Retinal Vessels / diagnostic imaging
  • Retinal Vessels / drug effects
  • Retinal Vessels / pathology*
  • Vasodilation / drug effects
  • Young Adult

Substances

  • Insulin
  • Glucose