diabetic eye disease

Common biological factors could guard against eye and heart complications in type 1 diabetes

by mfdfadmin on February 2, 2018

Scientists have found more clues as to how it may be possible to use common biological factors to guard against eye and heart complications in people with type 1 diabetes.

In people with type 1 diabetes, high levels of blood glucose eventually can harm blood vessels in the eye, kidney, heart and other organs, but the damage may be inflicted by different biological mechanisms in different organs.

(Stasique/Bigstock.com)

Scientists at Joslin Diabetes Centre in the United States have now shown that similar mechanisms may also be at work in the eye and the heart, giving valuable clues that eventually aid in developing therapies that defend against complications.

People with chronic kidney disease have much higher risk of cardiovascular disease, the leading cause of death for those with type 1 diabetes, but the Joslin team demonstrated that the eye condition known as proliferative diabetic retinopathy also is independently associated with cardiovascular disease.

‘This is an unexpected finding. It suggests that biological factors that either protect against or boost damage to blood vessels are shared between the eye and cardiovascular system, but they may be different from those affecting the kidney,’ said George King, Joslin senior vice president and chief scientific officer and professor at Harvard Medical School.

He explained that identifying this connection posed a particular challenge since people with type 1 diabetes who have chronic kidney disease also usually have severe eye damage.

When the researchers looked at the records of hundreds of participants in the Joslin Medallist programme which characterises people who have had the disease for more than 50 years, the scientists were able to spot 30 people who don’t have severe eye disease but do have chronic kidney disease.

Given the presence of kidney disease, the researchers expected these people also would experience significantly higher rates of cardiovascular disease than other people who are free of kidney disease. But surprisingly, that group doesn’t show much increase in cardiovascular disease.

Daniel Gordin, lead author on the paper, confirmed the discovery among a separate cohort of people with type 1 diabetes, the Finnish Diabetic Nephropathy (FinnDiane) study. He examined complications in people with at least 25 years of diabetes, by which time kidney disease usually occurs in those prone to the condition.

The study also reconfirmed other evidence that high blood glucose levels don’t injure all blood vessels in the same way. Nerve damage among patients with type 1 diabetes doesn’t display the same links to cardiovascular disease as does eye damage, once again suggesting a close connection between eye and cardiovascular damage.

Among their next steps, the scientists will analyse heart images of various groups to look for more detailed links between damage in heart muscles and damage to other organs. ‘We hope that will give us the next set of clues to understand and guard against these complications,’ said King.

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