|Year : 1982 | Volume
| Issue : 6 | Page : 617-620
Insulin antibody in diabetic retenopathy
RPS Bhatia, SK Gupta, PC Sen
Department of Opalmology and Microbiology, Institute of Medical Sciences, B. H. U. Varanasi, India
3 Surudham Durgakund Road Varanasi-221001
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bhatia R, Gupta S K, Sen P C. Insulin antibody in diabetic retenopathy. Indian J Ophthalmol 1982;30:617-20
The presence of insulin antibodies has been seen in patients of diabetes mellitus but none of the studies prove whether insulin antibodies have any direct role to play in production and progression of retirtopathic change in the eye. We have, therefore, undertaken this study to find out if these antibodies could be held responsible for retinopathic changes.
| Materials and methods|| |
This study was conducted on 20 normal individuals (Group A) and 47 diabetic patients (Group B).
History included details regarding duration of diabetes and the treatment taken whether regularly or irregularly. All these patients were subjected to detailed examinations and investigations. After funduscopy the cases divided into two series. The first series without retinopathy and second series showing evidence of diabetic retinal changes.
Laboratory investigations included urine for biochemical and microscopic tests, fasting and postprandial blood sugar and quantitative estimation of insulin antibodies by the method described by Moinat.(5)
| Observations|| |
All the cases studied were adults their age ranging from 21-80 years. The age and sex distribution is shown in [Figure - 1].
Grading of the diabetic patients with retinopathy was done according to Ballantyne's classification [Figure - 2]. We did not include the mixed forms of cases of diabetic retinopathy with hypertension i.e. of stage V.
The exact duation of diabetes in a patient could not be assessed with absolute certainty since a bulk of our patients failed to reveal the exact duration of the diseases. However in Group Bi (diabetes without retinopathy) duration between 1-5 years or 5-10 years embraced the maximum number of cases. In Group B2 (diabetes with retinopathy) most of the cases were of more than 10 years duration, it was evident that cases having a longer duration showed a higher prevalence of retinopathy [Figure - 3].
Patients of diabetes mellitus received three modes of treatment i.e. Insulin alone Insulin and oral and only oral antidiabetics.
Maximum number of patients received treatment with oral drugs. The number of cases receiving various modes of treatment is shown in [Figure - 4].
Level of antibody titre in various groups is shown in the [Table - 1].
It was observed that control group (A) showed an antibody titre from zero to 1:8 and group B1 upto 1:32 while group B 2 upto 1:128. A titre upto 1:8 was considered as nonspecific and we labelled positive insulin antibody titre cases from a dilution of 1:16 onwards [Figure - 5]. The [Table - 2] shows mean and S.D. of titre in different groups.
Insulin antibody titres in various stages in shown in [Figure - 6]. Statistical comparison of anybody titre between different stages of retinopathy was insignificant. Insulin antibody titre in various modes of treatment in two groups was insignificant.
| Summary|| |
Diabetics had significantly higher level of mean insulin antibody titre as compared to normal subjects. The difference was still more significant in diabetes with retinopathy as compared to without retinopathy and controls. The different stages of diabetic retinopathy maintained high value of titre but showed not much difference between them. There was no significant difference in levels of antibody titre and patients receiving various modes of treatment. So it may be concluded that exogenous insulin has no role in the production of insulin antibody but it is due to endogenous insulin which on slight modification produces insulin antibody both of which react at the level of basement membrane of capillaries of diabetic eyes and result in the production diabetic retinopatby of various stages
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6]
[Table - 1], [Table - 2], [Table - 3]