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November 1987

The Effect of Pregnancy on Diabetic Retinopathy-Reply

Arch Ophthalmol. 1987;105(11):1476. doi:10.1001/archopht.1987.01060110021004

In Reply.  —We appreciate the careful analysis of our data by Drs Pakalnis and Harp. In their letter, they have taken exception to our suggestion that the rate of deterioration of diabetic retinopathy during pregnancy may be related to the magnitude and perhaps the rapidity of improved diabetic control. By recalculating our data, they contend that the significant correlations between the changes in the glucose level and the changes in retinopathy disappear when adjustments are made for the correlation that we observed between the plasma glucose level at entry and subsequent changes in retinopathy. In other words, Pakalnis and Harp suggest that an initial elevated glucose level per se (and the putative poor control of diabetes) may be the major determinant of the subsequent retinal changes.This possibility cannot be entirely excluded. However, if we express the magnitude of change in the plasma glucose level as a percentage of the

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