Elevation of serum IGF-1 rather than sex steroids precedes proliferative diabetic retinopathy in Mauriac's syndrome.

We report the case of a 21-year-old man with Mauriac's syndrome, in whom diabetic retinopathy progressed to the proliferative state despite slightly improved glycemic control and completely suppressed sex steroids (by a GnRH agonist). However, a gradual increase in serum IGF-1 from 162 to 482 ng/ml over 9 months clearly preceded retinal deterioration, which responded to panretinal laser coagulation. We conclude that substantial elevation of serum IGF-1 may be another risk factor for the progression of mild diabetic retinopathy to the proliferative state.