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:: DIABETES N EWS
OF THE DAY: 
Treatment That Significantly Slows Progression Of Eye Damage
3th July 2009
University
of Minnesota Medical School researcher Michael Mauer, M.D.,
has found a treatment that significantly slows the
progression of eye injury in people with type 1 diabetes, a
common complication caused by this disease. By administering
an antihypertensive, medication commonly prescribed to treat
high blood pressure, Mauer and colleagues
 were
able to slow progression of diabetic eye damage in more than
65 percent of participants involved in the study.
Diabetes is the primary cause of acquired blindness in
adults and accounts for nearly half of all new cases of
chronic kidney failure in the Unites States each year, and
people living with the disease often struggle with these
complications as it progresses. Previous studies of people
with type 1 diabetes who were already exhibiting symptoms of
vision and kidney function loss showed that these types of
antihypertensive medications slowed further function loss in
the kidneys, but often could not prevent kidney failure.
Mauer and colleagues were interested in testing whether or
not they could delay diabetic kidney injury in participants
who had normal blood pressure and had not yet shown signs of
kidney disease at the beginning of the study.
Three groups of participants were observed over the course
of five years. Two groups were administered one of two
antihypertensive medications, losartan or enalapril, and the
last group, a placebo. The results were unexpected, but
conclusive. Mauer's study demonstrated that these drugs did
not protect the participants' kidneys from damage or from
losing function. However, participants who were administered
either enalapril or losartan experienced a significant
slowing of the progression of diabetic eye injury, by 65 and
70 percent, respectively.
 "The
secondary results of this study showed that people taking
these antihypertensive medications experienced a
substantially positive effect in slowing diabetic eye
injury," said Mauer, professor of pediatrics and medicine in
the Medical School. "Although neither medication delayed
early kidney tissue injury or early loss of kidney function,
the advantage to a study with negative findings such as this
one is that physicians now know that this treatment is
ineffective for this purpose, and they can pursue other
treatment options that may improve their patients'
outcomes."
Although the data does not support the use of these types
of antihypertensives to prevent kidney damage in people
living with diabetes, Mauer and colleagues find it
reasonable for physicians to consider prescribing these
classes of medication to people with type 1 diabetes in
order to slow the onset and progression of diabetic eye
disease. He notes, though, that this also poses several
other unanswered questions such as at what age a person with
diabetes should be prescribed this class of drug and how
long they should continue taking it.
Mauer's study "Renal and Retinal Effects of Enalapril and
Losartan in Type 1 Diabetes" is published in the July 2nd
issue of The New England Journal of Medicine. An editorial
accompanies the article.
The study was supported by research grants from the
National Institutes of Health (National Institute of
Diabetes and Digestive and Kidney Diseases), Merck (in the
United States), Merck Frosst (in Canada), and the Canadian
Institutes of Health Research.
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