Case 52 poor control and severe non-proliferative retinopathy
- 1968 date of birth, male, never smoked
- 1994 type 1 diabetes
- 2004 HbA1c 11.5
- 2008 HbA1c 7.9; first laser (CSME/prolif), never smoked, BP 150/96
- 2009 HbA1c 9.8
- 2010 HbA1c 8.0; severe non-proliferative retinopathy
This patient still has
not achieved good diabetic control. He has declined a place on the
DAFNE program, offered several times over the last year. Type 1 diabetes is
a difficult condition to control, and demands a great deal of time and
effort. But with the help of professionals, family, some intelligence
and a great deal of patient effort (testing glucose levels and adjusting
insulin doses etc) retinopathy be prevented /halted / delayed and good
To make matters worse, it takes several years of good control before the retinopathy does come under control.
Ischaemic haemorrhages indicate increasing retinopathy and generally poor diabetic control (yellow arrow).
Exudates are developing and grid laser was needed.
After years of gradual change the retinopathy starts to progress with increasing macular oedema (blue pointer). Photo/scan left 2010, photo/scan right 2009. On the graph: green line 2010; blue line 2009.