Progression of Retinopathy in Type 1 Diabetes
Research type
Research Study
Full title
Impact of insulin pump therapy and islet transplantation on progression of diabetic retinopathy in Type 1 diabetes.
IRAS ID
211912
Contact name
Shareen Forbes
Contact email
Sponsor organisation
University of Edinburgh
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Diabetes is a major cause of blindness. High blood glucose readings are associated with progressive complications from diabetes including those affecting the retina termed diabetic retinopathy.
When patients are switched to insulin pump therapy or undergo islet transplantation – a procedure involving the transplantation of donor islets into the liver which may lead to insulin independence, an improvement in their diabetes control may occur leading to an improvement in diabetic retinopathy in the longer term. However, following commencement of insulin pump therapy those with poor control and pre-existing diabetic retinopathy are susceptible to progression in diabetic retinopathy within the first year of therapy. Retinal eye screening allows the physician to intervene with therapy which might save eyesight. Therefore it is important to understand the particular patient groups may be most at risk for eye disease and the best time at which to perform retinal screening.We will follow subjects who have undergone conversion to insulin pump therapy or islet transplantation and serially examine their vision prior to and after this therapeutic intervention and relate changes in retinopathy to changes in their glucose control. We will use novel techniques of examining glucose control including Continuous Glucose Monitoring Systems which record glucose concentrations every three minutes over a six-day period. These tests will allow us to examine whether progression of retinopathy is related more to the improvement of blood glucose control per se or to a reduction in hyperglycaemia or a reduction in blood glucose variability. The study will also allow us to make objective assessments of nerve fibres by measuring vibration sensation in the feet and how this perception changes over time and its relationship to blood glucose control. The study will help inform screening strategies for islet transplantation and help refine those for insulin pump subjects, leading to improved medical outcomes.
REC name
South East Scotland REC 01
REC reference
16/SS/0198
Date of REC Opinion
30 Dec 2016
REC opinion
Further Information Favourable Opinion