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Eye Damage in Type 1 Diabetes

University of Minnesota Medical School researcher Michael Mauer, MD, has found a treatment that significantly slows the progression of eye injury in people with type 1 diabetes, a common complication caused by this disease. By administering an anti-hypertensive (medication commonly prescribed to treat high blood pressure), Mauer and colleagues were able to slow progression of diabetic eye damage in more than 65 percent of participants involved in the study published in the New England Journal of Medicine.
Three groups of participants with type 1 diabetes, normal blood pressure and no urine albumin were observed over the course of five years. Two groups were administered one of two anti-hypertensive medications, losartan or enalapril, and the last group, a placebo. The results were unexpected, but conclusive. Mauer’s study demonstrated that these drugs did not protect the participants’ kidneys from damage or from losing function as noted on kidney biopsy specimens. However, participants who were administered either enalapril or losartan experienced a significant slowing of the progression of diabetic eye injury, by 65 and 70 percent, respectively.

“The secondary results of this study showed that people taking these anti-hypertensive medications experienced a substantially positive effect in slowing diabetic eye injury,” said Mauer. “Although neither medication delayed early kidney tissue injury or early loss of kidney function, the advantage to a study with negative findings such as this one is that physicians now know that this treatment is ineffective for this purpose, and they can pursue other treatment options that may improve their patients’ outcomes.”

Although the data does not support the use of these types of anti hypertensives to prevent kidney damage in people living with diabetes, Mauer and colleagues find it reasonable for physicians to consider prescribing these classes of medication to people with type I diabetes in order to slow the onset and progression of diabetic eye disease.

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