Document Detail

Improved metabolic control results in better myogenic response of retinal arterioles in patients with diabetes mellitus type 1.
MedLine Citation:
PMID:  18698147     Owner:  NLM     Status:  MEDLINE    
AIMS: The retina is protected against high blood pressure by the myogenic constriction of arterioles (the Bayliss effect). Hyperglycemia impairs this retinal autoregulation by endothelial dysfunction. The purpose of this prospective pilot study was to test whether improved metabolic control results in a measurable effect on the myogenic response of human retinal arterioles to acute increases in blood pressure. METHODS: The Bayliss effect was measured in 25 patients with diabetes mellitus by the Retinal Vessel Analyzer (RVA), both before and after participation in a treatment and teaching program for intensified insulin therapy with the goal of improved metabolic control. After 12 months, 17 subjects still fulfilled the inclusion criteria and underwent an identical measurement. The Wilcoxon test was used for statistical analysis. RESULTS: During the first session, a rise in mean arterial pressure (MAP) of 20.2 +/- 8.6 mm Hg was followed by an arterial vasoconstriction of -3.2 +/- 2.9%. The educational program resulted in a significant drop in Hb(A1c) levels (9.4 +/- 1.9 vs. 6.9 +/- 0.98%). Eight subjects did not meet the inclusion criteria after 12 months. Seventeen subjects were remeasured and a rise in blood pressure of 19.5 +/- 9.9 mm Hg in the second session was associated with a significantly improved arterial vasoconstriction of -5.9 +/- 2.7% (session I vs. session II, p = 0.006). CONCLUSION: The myogenic response of the arterial wall in human retinal arterioles was significantly improved by the therapeutic intervention.
M Blum; C Kloos; S Günther; W Hunger-Dathe; U A Müller
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-08-13
Journal Detail:
Title:  Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift für Augenheilkunde     Volume:  222     ISSN:  1423-0267     ISO Abbreviation:  Ophthalmologica     Publication Date:  2008  
Date Detail:
Created Date:  2008-12-10     Completed Date:  2009-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0054655     Medline TA:  Ophthalmologica     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  373-7     Citation Subset:  IM    
Department of Ophthalmology, Helios Klinikum Erfurt, Erfurt, Germany.
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MeSH Terms
Arterioles / metabolism,  physiopathology
Blood Glucose / metabolism
Blood Pressure / physiology
Chromatography, High Pressure Liquid
Diabetes Mellitus, Type 1 / metabolism*,  physiopathology
Energy Metabolism / physiology*
Follow-Up Studies
Insulin / blood
Muscle, Smooth, Vascular / physiopathology*
Pilot Projects
Prospective Studies
Retinal Artery / metabolism*,  physiopathology
Vasoconstriction / physiology
Reg. No./Substance:
0/Blood Glucose; 11061-68-0/Insulin

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