Metformin use associated with protective effects for ocular complications in patients with type 2 diabetes – observational study

Maleškić, Sanita; Kusturica, Jasna; Gušić, Edis; Rakanović-Todić, Maida; Šečić, Damir; Burnazović-Ristić, Lejla; Kulo, Aida

doi:10.5644/ama2006-124.196

Cited by 31 publications

(30 citation statements)

References 23 publications

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“…As age-related tissue effects changes significantly contribute to glaucoma development [4], the antiaging effect of metformin as a calorie restriction (CR) mimetic could delay the progression of disease [120]. Similar results were found in an observational study by Maleskic et al of 234 patients with T2DM, which showed that metformin was associated with decreased odds of POAG (OR = 0.33) compared to other anti-hyperglycaemic agents (p = 0.017) [15]. Interestingly a separate study, in which metformin use was significantly associated with elevated IOP in participants using a high dose (>2 g/day/year), systemic use of metformin was associated with a reduced risk of POAG, in a duration-dependent manner [121].…”

Section: Metforminsupporting

confidence: 59%

“…Metformin, a biguanide derivate commonly used in patients with type 2 diabetes, has come to be a front-runner recently in addressing this need, following a line of publications linking its use in a diabetic population with reduced incidence of POAG [14,15]. The cellular mechanism through which metformin is acting to combat glaucoma is not yet understood but likely involves effects on the pathogenesis of fibrosis and mitochondrial bioenergetic dysfunction in glaucoma.…”

Section: Introductionmentioning

confidence: 99%

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Metformin and Glaucoma—Review of Anti-Fibrotic Processes and Bioenergetics

Hurley

Irnaten

O’Brien

2021

Cells

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Glaucoma is the leading cause of irreversible blindness globally. With an aging population, disease incidence will rise with an enormous societal and economic burden. The treatment strategy revolves around targeting intraocular pressure, the principle modifiable risk factor, to slow progression of disease. However, there is a clear unmet clinical need to find a novel therapeutic approach that targets and halts the retinal ganglion cell (RGC) degeneration that occurs with fibrosis. RGCs are highly sensitive to metabolic fluctuations as a result of multiple stressors and thus their viability depends on healthy mitochondrial functioning. Metformin, known for its use in type 2 diabetes, has come to the forefront of medical research in multiple organ systems. Its use was recently associated with a 25% reduced risk of glaucoma in a large population study. Here, we discuss its application to glaucoma therapy, highlighting its effect on fibrotic signalling pathways, mitochondrial bioenergetics and NAD oxidation.

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Section: Metforminsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Metformin and Glaucoma—Review of Anti-Fibrotic Processes and Bioenergetics

Hurley

Irnaten

O’Brien

2021

Cells

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“…The literature suggests that the increased risk of glaucoma in patients with diabetes is due to increased corneal stiffness, corneal hysteresis, and enlargement of the optic cup. [ 9 ] In our study, IOP was found to be increased in diabetics than the nondiabetics whereas there was no difference in VCDR among diabetics and non-diabetics.…”

Section: Discussioncontrasting

confidence: 44%

Association of metformin use among diabetics and the incidence of primary open-angle glaucoma – The Chennai Eye Disease Incidence Study

George

Asokan

Vijaya

2021

Indian Journal of Ophthalmology

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Purpose: Studies have reported the usage of metformin being associated with the reduced risk of progression of glaucoma. The current study aims to determine the association of metformin usage among subjects with diabetes mellitus and the six-year incidence of primary open-angle glaucoma (POAG). Methods: In this prospective cohort study, subjects who did not have glaucoma at the baseline and had a follow-up after a six-year interval were included. Details such as medical and drug history, applanation tonometry, gonioscopy, pachymetry, optic disc evaluation, and automated perimetry were collected. Incident POAG was defined as subjects who do not have glaucoma at baseline and developed glaucoma as classified International Society of Geographical and Epidemiological Ophthalmology Classification at the follow-up. The association between the subjects who were on metformin for treatment of diabetes mellitus and development of incident POAG was assessed. Results: Among the 4302 eligible participants, 128 (3%) had incident POAG. There were 905 (21.0%) subjects who had diabetes mellitus of which 142 (15.7%) were using metformin. Of the subjects with POAG, 92 (71.9%) were nondiabetics and 36 were diabetics (28.1%). Among the diabetics, the incidence of POAG among those on metformin was 5.6% (8 participants) and those not on metformin was 3.6% (28 participants). There was no difference in the incidence of POAG in subjects with diabetes mellitus, with and without metformin use ( P = 0.25). Logistic regression showed no association of metformin use with the incidence of POAG (OR: 1.33, 95 CI: 0.58–3.04, P = 0.49) after adjusting for age, gender, and place of residence. Conclusion: The current study did not find any association between the effects of metformin on the incidence of POAG.

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“…[ 3 4 5 ] AMPK upregulation alters the tone of cells in the trabecular meshwork, thus lowering the IOP and preventing the progression of glaucoma. [ 6 7 ] Preliminary results from animal studies have also shown that metformin exerts neuroprotective effect by upregulation of AMPK. Metformin regulates the methylation at cellular levels and promotes ganglion cell survival.…”

mentioning

confidence: 99%

“…Maleškić et al . [ 6 ] postulated that the gero-protective effect of metformin could delay tissue damage, which can be a major factor in delaying the progression of glaucoma. Lin et al .…”

mentioning

confidence: 99%

Commentary - Association of metformin use among diabetics and the incidence of primary open-angle glaucoma – The Chennai Eye Disease Incidence Study

Kumar

2021

Indian Journal of Ophthalmology

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Metformin use associated with protective effects for ocular complications in patients with type 2 diabetes – observational study

Cited by 31 publications

References 23 publications

Metformin and Glaucoma—Review of Anti-Fibrotic Processes and Bioenergetics

Metformin and Glaucoma—Review of Anti-Fibrotic Processes and Bioenergetics

Association of metformin use among diabetics and the incidence of primary open-angle glaucoma – The Chennai Eye Disease Incidence Study

Commentary - Association of metformin use among diabetics and the incidence of primary open-angle glaucoma – The Chennai Eye Disease Incidence Study

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