Impact of Insulin Treatment in Diabetic Macular Edema Therapy in Type 2 Diabetes

Página do item simplificado
dc.contributor.authorMatsuda, Simone [UNIFESP]
dc.contributor.authorTam, Tiffany
dc.contributor.authorSingh, Rishi P.
dc.contributor.authorKaiser, Peter K.
dc.contributor.authorPetkovsek, Daniel
dc.contributor.authorZanella, Maria Teresa [UNIFESP]
dc.contributor.authorEhlers, Justis P.
dc.contributor.institutionCleveland Clin Fdn
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:39:55Z
dc.date.available2016-01-24T14:39:55Z
dc.date.issued2015-02-01
dc.description.abstractObjective: To evaluate the impact of insulin therapy on the outcomes of diabetic macular edema (DME) treatment with vascular endothelial growth factor (VEGF) inhibitors in people with type 2 diabetes.Methods: A retrospective consecutive case series of 95 patients with type 2 diabetes and DME who were treated with anti-VEGF therapy. We examined 2 cohorts: patients taking only oral antidiabetic agents and patients on insulin therapy. the main outcome measures were change in visual acuity and change in central subfield macular thickness measured by spectral-domain optical coherence tomography. the additional variables analyzed included glycated hemoglobin (A1C), creatinine, blood pressure and body mass index and their correlations with clinical findings.Results: Both groups had a statistically significant improvement in visual acuity (oral antidiabetic agents group: 20/61 to 20/49, p=0.003; insulin therapy group: 20/76 to 20/56, p=0.005). There was no difference between groups at initial or 12-month examination (p=0.239 and p=0.489, respectively). From an anatomic standpoint, central subfield macular thickness also improved significantly in both groups: from 454.7 mu m to 354.9 mu m (p<0.001) in the oral antidiabetic agents group and from 471.5 mu m to 368.4 mu m (p<0.001) in the insulin therapy group. Again, there was no significant difference between groups at initial or 12-month follow-up examinations (p=0.586 and p=0.591, respectively). Mean A1C levels remained relatively stable during the follow up in both groups.Conclusion: Anti-VEGF therapy is a useful treatment for DME. This study Suggests that chronic insulin therapy, compared with oral antidiabetic agents, does not modify the anatomic or functional effectiveness of DME treatment. (C) 2015 Canadian Diabetes Associationen
dc.description.affiliationCleveland Clin Fdn, Cole Eye Inst, Ophthalm Imaging Ctr, Cleveland, OH 44195 USA
dc.description.affiliationUniversidade Federal de São Paulo, Div Endocrinol, Dept Med, São Paulo, SP, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Div Endocrinol, Dept Med, São Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
dc.description.sponsorshipNIH/NEI
dc.description.sponsorshipResearch to Prevent Blindness
dc.description.sponsorshipGenentech
dc.description.sponsorshipIDCAPES: 1541-12-9
dc.description.sponsorshipIDNIH/NEI: K23-EY022947-01A1
dc.format.extent73-77
dc.identifierhttp://dx.doi.org/10.1016/j.jcjd.2014.06.005
dc.identifier.citationCanadian Journal of Diabetes. Amsterdam: Elsevier B.V., v. 39, n. 1, p. 73-77, 2015.
dc.identifier.doi10.1016/j.jcjd.2014.06.005
dc.identifier.issn1499-2671
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/38646
dc.identifier.wosWOS:000350530100015
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofCanadian Journal of Diabetes
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectaflibercepten
dc.subjectAvastin (TM)en
dc.subjectbevacizumaben
dc.subjectdiabetic macular edemaen
dc.subjectdiabetic retinopathyen
dc.subjectglycated hemoglobin (A1C)en
dc.subjectinsulin therapyen
dc.subjectmetabolic parametersen
dc.subjectranibizumaben
dc.subjectVEGF-inhibitorsen
dc.titleImpact of Insulin Treatment in Diabetic Macular Edema Therapy in Type 2 Diabetesen
dc.typeinfo:eu-repo/semantics/article
Arquivos
Coleções
Em verificação - Geral