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The Effect of Pregnancy on Diabetic Retinopathy-Reply FREE

Richard L. Phelps, MD; Peter Sakol, MD; Boyd E. Metzger, MD; Lee M. Jampol, MD; Kiang Liu, PhD; Norbert Freinkel, MD
Arch Ophthalmol. 1987;105(11):1476-1476. doi:10.1001/archopht.1987.01060110021004
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In Reply.  —We appreciate the careful analysis of our data by Drs Pakalnis and Harp. In their letter, they have taken exception to our suggestion that the rate of deterioration of diabetic retinopathy during pregnancy may be related to the magnitude and perhaps the rapidity of improved diabetic control. By recalculating our data, they contend that the significant correlations between the changes in the glucose level and the changes in retinopathy disappear when adjustments are made for the correlation that we observed between the plasma glucose level at entry and subsequent changes in retinopathy. In other words, Pakalnis and Harp suggest that an initial elevated glucose level per se (and the putative poor control of diabetes) may be the major determinant of the subsequent retinal changes.This possibility cannot be entirely excluded. However, if we express the magnitude of change in the plasma glucose level as a percentage of the

REFERENCES

Lauritzen T, Larsen KF, Larsen H, et al:  Effect of one year of near-normal blood glucose levels on retinopathy in insulin-dependent diabetics . Lancet 1983;;1:200-203.
The Kroc Collaborative Study Group:  Blood glucose control and the evolution of diabetic retinopathy and albuminuria . N Engl J Med 1984;;311:365-372.
Van Ballegooie E, Hooymans JMM, Timmerman Z, et al:  Rapid deterioration of diabetic retinopathy during treatments with continuous subcutaneous insulin infusion . Diabetes Care 1984;;7:236.
Brinchmann-Hansen O, Dahl-Jorgensen K, Hanssen KF, et al:  Effects of intensified insulin treatment on various lesions of diabetic retinopathy . Am J Ophthalmol 1985;;100:644-653.
Freinkel N, Dooley SL, Metzger BE:  Care of the pregnant woman with insulin-dependent diabetes mellitus . N Engl J Med 1985;;313:96-101.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Lauritzen T, Larsen KF, Larsen H, et al:  Effect of one year of near-normal blood glucose levels on retinopathy in insulin-dependent diabetics . Lancet 1983;;1:200-203.
The Kroc Collaborative Study Group:  Blood glucose control and the evolution of diabetic retinopathy and albuminuria . N Engl J Med 1984;;311:365-372.
Van Ballegooie E, Hooymans JMM, Timmerman Z, et al:  Rapid deterioration of diabetic retinopathy during treatments with continuous subcutaneous insulin infusion . Diabetes Care 1984;;7:236.
Brinchmann-Hansen O, Dahl-Jorgensen K, Hanssen KF, et al:  Effects of intensified insulin treatment on various lesions of diabetic retinopathy . Am J Ophthalmol 1985;;100:644-653.
Freinkel N, Dooley SL, Metzger BE:  Care of the pregnant woman with insulin-dependent diabetes mellitus . N Engl J Med 1985;;313:96-101.

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