Aspirin Could Preserve Sight in Diabetics

NEW YORK (Reuters Health) - People with diabetes have many blood clots in the tiny blood vessels of the retina, researchers have found. Based on their findings, they suggest that drugs to dissolve blood clots could help prevent a type of eye damage common in diabetic patients.

Researchers from the Schepens Eye Research Institute, Harvard Medical School, in Boston, examined donated retinas from nine people with diabetes and eight nondiabetic individuals. They found that the capillaries within the diabetic patients' retinas contained many more, and larger, blood clots than those of the healthy individuals.

``This is something that has been suspected to be part of the mechanism of diabetic retinopathy, but it had never before been demonstrated in humans,'' Dr. Mara Lorenzi told Reuters Health. Lorenzi conducted the study with her colleagues Dr. Daria Boeri and Dr. Michele Maiello, both from the University of Genoa, Italy.

High blood sugar levels associated with diabetes can damage the blood vessels in the retina. This progressive damage can eventually threaten sight, and nearly everyone who has lived with diabetes for 30 years has some degree of retinal damage, according to the National Institutes of Health. Diabetic retinopathy leads to blindness in 8,000 people each year in the United States.

The research teams' findings suggest that blood clots like those that they observed eventually block capillaries. ''Progressive capillary occlusion is what transforms early and asymptomatic diabetic retinopathy into sight-threatening proliferative retinopathy,'' Lorenzi told Reuters Health.

Lorenzi pointed out that since the blood clots she and her colleagues found consist of platelets and fibrin, antiplatelet agents such as aspirin could help prevent them from forming and blocking the capillaries. The American Diabetes Association has long encouraged the early use of aspirin in diabetic patients to prevent heart and blood vessel disease, Lorenzi said, and her study gives people with diabetes another reason to use aspirin.

``The first and best line of defense is good control of the high blood glucose, to keep blood glucose as close as possible to normal levels. In diabetic patients who also have high blood pressure, control of the high blood pressure is also important,'' Lorenzi told Reuters Health.

``Our study suggests that aspirin may add a further measure of protection, especially if begun early after discovery of diabetes,'' she added.

SOURCE: Diabetes 2001;50:1432-1439.

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