Assuntos
Angiopatias Diabéticas/genética , Antígenos HLA/genética , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/imunologia , Angiopatias Diabéticas/imunologia , Nefropatias Diabéticas/genética , Nefropatias Diabéticas/imunologia , Retinopatia Diabética/genética , Retinopatia Diabética/imunologia , HumanosRESUMO
The incidence of diabetic retinopathy was evaluated by means of fluorescein angiography in 54 patients with diabetes secondary to chronic pancreatitis or to pancreatectomy. Thirty-one percent of the patients had background retinopathy; none had proliferative retinopathy. The percentage of patients with retinopathy was the same in groups with or without a family history of diabetes. There was no correlation between the degree of metabolic control, the levels of C-peptide, glucagon, growth hormone, and the presence of retinopathy. Retinopathy was correlated with the duration of diabetes. In conclusion, diabetes caused by pancreatitis or pancreatectomy has a significant prevalence of retinopathy, which has more benign characteristics and slower evolution than the retinopathy in patients with primary diabetes.
Assuntos
Diabetes Mellitus/etiologia , Retinopatia Diabética/etiologia , Pancreatectomia , Pancreatite/complicações , Adulto , Doença Crônica , Diabetes Mellitus/metabolismo , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/metabolismo , Feminino , Angiofluoresceinografia , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmoscopia , Complicações Pós-OperatóriasRESUMO
In three groups of patients with insulin-dependent diabetes following total (n = 5) or partial (n = 5) pancreatectomy or chronic pancreatitis (n = 7) and in a group of idiopathic diabetics, ketogenic capacity following insulin withdrawal and during a 24-h fast was studied. Basal glucagon values were significantly increased in all diabetic groups with no significant intergroup differences. Basal ketone body values and their increase during starvation and insulin withdrawal were high and not different in totally pancreatectomized and primary diabetics, both showing unmeasurable C-peptide levels. On the contrary, ketogenesis was reduced in partially pancreatectomized and in pancreatitis diabetics with persistent levels of C-peptide. Our data confirmed the persistence of immunoreactive glucagon after pancreatectomy and demonstrated that ketogenesis is not suppressed in pancreatectomized diabetics and depends above all on residual B-cell function. A possible ketogenic effect of extra-pancreatic glucagon-like substances cannot be excluded.
