passages: 3485
passages: document
passages: Rapid tightening of blood glucose control leads to transient deterioration of retinopathy in insulin dependent diabetes mellitus : the Oslo study . In a study of retinopathy during one year of tight blood glucose control 45 type I ( insulin dependent ) diabetics without proliferative retinopathy were randomised to receive either continuous subcutaneous insulin infusion , multiple insulin injections , or conventional insulin treatment ( controls ) . Near normoglycaemia was achieved with continuous infusion and multiple injections but not with conventional treatment . Blind evaluation of fluorescein angiograms performed three monthly showed progression of retinopathy in the control group , transient deterioration in the continuous infusion group , and no change in the multiple injection group . Half the patients receiving continuous infusion and multiple injections developed retinal cotton wool spots after three to six months . These changes regressed in all but four patients after 12 months . Control patients did not develop cotton wool spots . Patients who developed cotton wool spots are characterised by a larger decrement in glycosylated haemoglobin and blood glucose values , more frequent episodes of hypoglycaemia , a longer duration of diabetes , and more severe retinopathy at onset . A large and rapid fall in blood glucose concentration may promote transient deterioration of diabetic retinopathy .
entities: 3486
entities: Intervention_Pharmacological
entities: insulin infusion
entities: 3487
entities: Intervention_Pharmacological
entities: insulin injections
entities: 3488
entities: Intervention_Pharmacological
entities: insulin treatment
entities: 3489
entities: Outcome_Physical
entities: retinopathy
entities: 3490
entities: Outcome_Physical
entities: fluorescein angiograms
entities: 3491
entities: Outcome_Physical
entities: progression of retinopathy
entities: 3492
entities: Outcome_Physical
entities: cotton wool spots .
entities: 3493
entities: Outcome_Physical
entities: glycosylated haemoglobin
entities: 3494
entities: Outcome_Physical
entities: blood glucose values
entities: 3495
entities: Outcome_Physical
entities: episodes of hypoglycaemia
entities: 3496
entities: Outcome_Physical
entities: duration of diabetes
entities: 3497
entities: Outcome_Physical
entities: retinopathy
entities: 3498
entities: Outcome_Physical
entities: blood glucose concentration
entities: 3499
entities: Participant_Condition
entities: insulin dependent diabetes mellitus :
entities: 3500
entities: Participant_Sample-size
entities: 45
entities: 3501
entities: Participant_Condition
entities: type I ( insulin dependent ) diabetics without proliferative retinopathy