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Researchers suggest hyperglycemia, hypoxia instigate diabetic retinopathy

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Hyperglycemia and hypoxia may increase the release of free radicals in patients with diabetes, which in turn may be a root cause of diabetic retinopathy, a group of researchers at Washington University in St. Louis suggested.

Joseph R. Williamson, MD, and colleagues induced hyperglycemia and hypoxia in rat retinas in vitro to observe how these conditions altered the retinal blood vessels. Long-term exposure to these processes may causes the retinal damage seen in diabetics, the researchers speculate.

Dr. Williamson noted that patients with diabetes have elevated blood sugar levels, and tissues damaged by diabetes have low oxygen levels. Those two conditions, hyperglycemia and hypoxia, cause a decrease in the ratio of nicotinamide adenine dinucleotide (NAD) to NADH (NAD plus one hydrogen atom). The increased NADH is recycled back to NAD by processes that produce free radicals that can damage tissue, Dr. Williamson said in a press release from Washington University.

“The ratio of NAD to NADH varies in different types of tissues, ranging from 500 to 1 to 2,000 to 1. In diabetics, though, that ratio can drop as low as 200-to-1,” Dr. Williamson said in the release.

The study is published in the November issue of Diabetes.