Influence of the metabolic control on latency values of visual evoked potentials (VEP) in patients with diabetes mellitus type 1.

The aim of our study was to investigate the relationship between the metabolic control parameters of diabetes mellitus (glycemia and HbA1c) and visual evoked potentials (VEP) latency values. The study included 61 patients with diabetes mellitus type 1 that were hospitalized at the Clinic for Endocrinology, Diabetes and Metabolic Diseases due to the poor metabolic control. All patients were divided into 3 groups. Group 1 consisted of patients on conventional insulin therapy (CT); Group 2 included patients on CT at the moment of hospitalization, with a change towards intensified insulin therapy (IIT); and Group 3 consisted of patients on IIT. Patients with diabetic retinopathy (DR) were excluded from the study. Metabolic control (glycemia and HbA1c) and VEP parameters were compared at the beginning of the study and six months later. After six months of strict glycoregulation, significant improvement in VEP parameters was followed by significant improvement of evaluated parameters of metabolic control. We found statistically significant reduction in frequency of pathological VEP findings, prolonged P100 latency and low amplitude potentials in Group 2, while in Groups 1 and 3 we found that these parameters did not significantly changed but the frequencies were lower. The VEP testing is a noninvasive diagnostic procedure which may help in early diagnosis of DR, prognosis during the metabolic control and treatment. If changes in the retina could be detected before DR is noticed using this noninvasive diagnostic procedure and include patients in a strict glycoregulation, we could be in the position to prevent serious complications that may cause blindness.