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Publication date: 2004-12-31
Pol. J. Food Nutr. Sci. 2004;54(4):391-396
The purpose of this article was to study the possible interaction and relation between vitamin A status in diabetic retinopathy and the state of proliferative changes occurring in these cases. Twenty five healthy and sixty diabetic retinopathy patients were included in this study. Diabetic patients were classified into four groups according to the type of diabetic retinopathy. Group 1: normal fundus; Group 2: proliferative; Group 3: non-proliferative and Group 4: hard with exudate Groups were further classified into 3 subgroups according to the route of treatment; whether receiving insulin therapy alone or oral hypoglycemic tablets or both. The level of serum glucose, insulin, retinol binding protein (RBP), vitamin A and β-carotene were estimated for all groups. The fasting blood glucose and glycosylated hemoglobin levels of patients suffering from diabetic retinopathy were high in all diabetic groups. The highest levels were noticed among proliferative group. Cases with normal fundus receiving insulin therapy had the lowest levels of blood sugar. Serum insulin level was markedly high in all diabetic groups when compared within control values, markedly higher among those who received oral hypoglycemic tablets alone. Serum vitamin A and β-carotene levels were significantly decreased in all groups of patients, the lowest was attained for proliferative group receiving insulin. The level of RBP was significantly high in all diabetic groups. Serum RBP was markedly low in the subgroup of patients under insulin therapy. It was concluded that the patients with diabetic retinopathy included in this study suffer from a state of non controlled hyperglycemia which induces the generation of free radicals. This state together with decreased level of the antioxidant, β- carotene or vitamin A results in a state of retinal damage. The deficiency of vitamin A is believed to participate in the phenomena of retinal cell proliferation.
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