Type 2 Diabetes Mellitus and the Risk of Open-angle Glaucoma

Abstract

Purpose-To examine the relationship between type 2 diabetes mellitus (T2DM) and the risk of having open-angle glaucoma (OAG) in an adult Latino population. Design-Population-based cross-sectional study.Participants-Latinos 40 years and older (n = 5894) from 6 census tracts in Los Angeles, California. Methods-Participants from the Los Angeles Latino Eye Study (LALES), a large populationbased study of self-identified adult Latinos, answered an interviewer-administered questionnaire and underwent a clinical and complete ocular examination, including visual field (VF) testing and stereo fundus photography. A participant was defined as having diabetes mellitus (DM) if she or he had a history of being treated for DM, the participant's glycosylated hemoglobin was measured at 7.0% or higher, or the participant had random blood glucose of 200 mg% or higher. Type 2 DM was defined if the participant was 30 years or older when diagnosed with DM. Open-angle glaucoma was defined as the presence of an open angle and a glaucomatous VF abnormality and/or evidence of glaucomatous optic disc damage in at least one eye. Logistic regression analysis was used to identify the risk of having OAG in persons with T2DM. Main Outcome Measure-Prevalence of OAG.Results-Of the 5894 participants with complete data, 1157 (19.6%) had T2DM and 288 (4.9%) had OAG. The prevalence of OAG was 40% higher in participants with T2DM than in those without T2DM (age/gender/intraocular pressure-adjusted odds ratio, 1.4; 95% confidence interval, HHS Public Access Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript 1.03-1.8; P = 0.03). Trend analysis revealed that a longer duration of T2DM (stratified into 5-year increments) was associated with a higher prevalence of OAG (P<0.0001). Conclusion-The Participants and Methods DesignParticipants were identified through the LALES, 18 a large population-based survey, from 2000 to 2003. The LALES was designed to estimate the prevalence of ocular disease, associated risk factors, quality of life, and access to health care in noninstitutionalized selfidentified adult Latinos, 40 years and older, living in the city of La Puente, California. The LALES survey methods and socioeconomic characteristics of LALES participants have been described in detail previously. 18 In the LALES, 82% (n = 6357) of eligible persons (n = 7789) completed the clinical examination. 18 Participants with incomplete data (n = 463) were excluded from the analyses. Thus, our cross-sectional study cohort consisted of 5894 consecutively enrolled adult Latinos, predominantly of Mexican ancestry, who completed an in-home interview and a complete clinical eye examination, as well as additional laboratory testing for diabetes. The institutional review board at the University of Southern California approved the study protocol, and all study procedures conformed to the Health Insurance Clinical Procedures and DefinitionsAfter informed consent was obtained, participants underwent a complete ophthalmic examination, including det...

Vascular Dysfunction in Diabetes and Glaucoma

“…18,20 Bonovas and colleagues conducted a metaanalysis examining the relationship between diabetes and primary OAG (POAG). They reviewed a total of 12 studies published between 1987 and 2001, which included 5 casecontrol and 7 cross-sectional studies.…”

“…[15][16][17] Likewise, vascular dysregulation has been well documented in diabetic patients and has been hypothesized to cause downstream microvascular consequences, including retinopathy and neuropathy. 18,19 As vascular abnormalities are associated with both diseases and these deficits may predispose patients toward a comorbid state, further evaluation to determine whether OAG patients with diabetes are more prone to glaucomatous progression is essential.…”

The Impact of Metformin Treatment in Glaucoma of Diabetic Patients

“…In literature, studies gave various outcomes regarding the relationship between glaucoma and diabetes. Some studies have confirmed a significant relationship between diabetes and glaucoma which implies metformin use and dose [8][9] . On the other hand, other studies did not confirm such a relationship [10][11] .…”

“…The relationship between DM and glaucoma was investigated through several studies; some studies reported significant relationship [8][9] . Other studies did not report a significant relationship between DM and glaucoma [10][11] .…”

Impact of Panretinal Photocoagulation on Optic Nerve Head Parameters

“…Diabetes mellitus is considered an important risk factor for primary open-angle glaucoma [1]. Moreover, diabetic retinopathy often coexists with glaucomatous optic neuropathy.…”