Does Carvedilol Reduce Requirements for Laser Photocoagulation in Diabetic Retinopathy to a Minimum?
¿Minimiza el carvedilol los requerimientos de fotocoagulación láser en la retinopatía diabética?
I.. Auyaneta, L.J.. Rodríguezb, N.. Esparzaa, F.. Cabrerac, P.. Rossiquea, S.. Suriaa, P.. Cardonab, M.D.. Checaa
a Servicio de Nefrología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria
b Servicio de Oftalmología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria
c Servicio de Oftalmología, Hospital Universitario Insular de Gran Canaria Las Palmas de Gran Canaria
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To achieve this it is necessary to use combined therapies.<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">Given the close relationship between diabetic retinopathy, diabetic nephropathy and hypertension, we have studied 63 patients with diabetic nephropathy due to diabetes mellitus type 2 (DM2) who came in to our outpatient offices consecutively. The patients had a mean age of 65.24 + 7.47 years, 26 were women and 37 were men. Statistical analysis was carried out with the statistical software package SPSS 15.0 for Windows.</p><p class="elsevierStylePara">The patients were divided into 2 subgroups: one group that had not received photocoagulation (n = 26) and another group that had received it (n = 37). The clinical characteristics and the number of patients treated with carvedilol in both subgroups can be seen in Table 1.</p><p class="elsevierStylePara">In the subgroup of patients that had not received photocoagulation, 35.7% were being treated with carvedilol in comparison with 14.3% in the group who had received photocoagulation (p = 0.017). Since there were no differences in their mean blood pressure, it can be inferred that the effect of carvedilol is independent of its hypotensive effect.</p><p class="elsevierStylePara">Carvedilol has a blocking effect on beta-adrenergic receptors combined with vasodilator action based on the blockage of alfa-1-adrenergic<span class="elsevierStyleSup">3 </span>receptors. In experimental studies carvedilol has been shown to have protective and antioxidant<span class="elsevierStyleSup">4</span> effects on perivascular inflammation.<span class="elsevierStyleSup">5 </span>These effects could, in part, be explained by the results of our study. Although it is probably limited by the number of patients studied, the finding that the percentage of patients who received carvedilol in the subgroup that did not receive photocoagulation is significantly higher than in the group that did receive photocoagulation should be taken into account when treating patients suffering from diabetic nephropathy. Subsequent studies should evaluate if carvedilol prevents the development of diabetic retinopathy.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Acknowledgements</span></p><p class="elsevierStylePara">The authors wish to acknowledge Professor Limiñana for his help with the statistics.</p><p class="elsevierStylePara"><a href="grande/10386_108_7824_en_10386_es_t1.jpg" class="elsevierStyleCrossRefs"><img src="10386_108_7824_en_10386_es_t1.jpg" alt="Subgroups of patients with diabetic nephropathy caused by DM2 based on whether they had or not received photocoagulation"></img></a></p><p class="elsevierStylePara">Table 1. Subgroups of patients with diabetic nephropathy caused by DM2 based on whether they had or not received photocoagulation</p>" "pdfFichero" => "P1-E501-S2461-A10386-EN.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig1" "etiqueta" => "Tab. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10386_108_7824_en_10386_es_t1.jpg" "Alto" => 444 "Ancho" => 663 "Tamanyo" => 41789 ] ] "descripcion" => array:1 [ "en" => "Subgroups of patients with diabetic nephropathy caused by DM2 based on whether they had or not received photocoagulation" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Standars of Medical Care in Diabetes-2009. Diabetes Care 2009;32(Suppl 1):S13-S61. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19118286" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "UKPDS 38: UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes. Br Med J 1998;317:703-13." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Hansson L, Himmielmann A. Carvedilol in the treatment of hypertension-a review of the clinical data base. Scand Cardiovasc J Suppl 1998;47:67-80. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9540136" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Huang H, Shan J, Pan X, Wang H. Carvedilol protected diabetic rat hearts via reducing oxidative stress. Univ Sci B 2006;7(9):725¿31." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Vailati Mdo C, Rocha NS, Matsubara LS, et al. Protective effects of carvedilol on systemic vascular damage induced by angiotension II: organ-especific effects independent of antihypertensive effects. Med Sci Monit 2010;16(1):6-10. 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| 2019 September | 14 | 13 | 27 |
| 2019 August | 10 | 4 | 14 |
| 2019 July | 17 | 24 | 41 |
| 2019 June | 23 | 9 | 32 |
| 2019 May | 19 | 14 | 33 |
| 2019 April | 44 | 34 | 78 |
| 2019 March | 18 | 19 | 37 |
| 2019 February | 19 | 10 | 29 |
| 2019 January | 23 | 15 | 38 |
| 2018 December | 67 | 32 | 99 |
| 2018 November | 79 | 28 | 107 |
| 2018 October | 68 | 15 | 83 |
| 2018 September | 52 | 12 | 64 |
| 2018 August | 37 | 15 | 52 |
| 2018 July | 42 | 13 | 55 |
| 2018 June | 40 | 12 | 52 |
| 2018 May | 34 | 13 | 47 |
| 2018 April | 37 | 11 | 48 |
| 2018 March | 31 | 6 | 37 |
| 2018 February | 29 | 5 | 34 |
| 2018 January | 28 | 4 | 32 |
| 2017 December | 37 | 7 | 44 |
| 2017 November | 16 | 7 | 23 |
| 2017 October | 30 | 1 | 31 |
| 2017 September | 29 | 12 | 41 |
| 2017 August | 22 | 8 | 30 |
| 2017 July | 30 | 12 | 42 |
| 2017 June | 20 | 4 | 24 |
| 2017 May | 36 | 12 | 48 |
| 2017 April | 21 | 7 | 28 |
| 2017 March | 18 | 3 | 21 |
| 2017 February | 15 | 3 | 18 |
| 2017 January | 17 | 7 | 24 |
| 2016 December | 34 | 4 | 38 |
| 2016 November | 30 | 5 | 35 |
| 2016 October | 61 | 5 | 66 |
| 2016 September | 80 | 3 | 83 |
| 2016 August | 113 | 5 | 118 |
| 2016 July | 139 | 1 | 140 |
| 2016 June | 109 | 0 | 109 |
| 2016 May | 113 | 0 | 113 |
| 2016 April | 57 | 0 | 57 |
| 2016 March | 65 | 0 | 65 |
| 2016 February | 70 | 0 | 70 |
| 2016 January | 80 | 0 | 80 |
| 2015 December | 97 | 0 | 97 |
| 2015 November | 71 | 0 | 71 |
| 2015 October | 69 | 0 | 69 |
| 2015 September | 56 | 0 | 56 |
| 2015 August | 69 | 0 | 69 |
| 2015 July | 49 | 0 | 49 |
| 2015 June | 24 | 0 | 24 |
| 2015 May | 49 | 0 | 49 |
| 2015 April | 6 | 0 | 6 |
Show all
