Manifest diabetes and keratoconus: a retrospective case-control study
1Department of Ophthalmology, University Hospital, Technical University of Dresden, Germany.
Summary
Manifest diabetes appears to protect against developing keratoconus, particularly type II diabetes. This finding suggests biomechanical changes in the cornea may influence disease development and epidemiology.
Area of Science:
- Ophthalmology
- Endocrinology
- Biomechanical Engineering
Background:
- Keratoconus is a progressive thinning of the cornea.
- Diabetes mellitus affects corneal biomechanics, with manifest diabetes stiffening the stroma.
- The epidemiological relationship between diabetes and keratoconus is not well understood.
Purpose of the Study:
- To investigate the influence of diabetes on keratoconus development.
- To determine if diabetes acts as a risk factor or protective factor for keratoconus.
- To explore the epidemiological implications of biomechanical changes in the cornea.
Main Methods:
- A retrospective case-control study involving 1,142 patients (571 keratoconus cases, 571 controls).
- Groups were matched for sex and age.
- Statistical analysis using odds ratio to compare diabetes prevalence between groups.
Main Results:
- A significantly lower prevalence of manifest diabetes was observed in the keratoconus group (2 patients) compared to the control group (9 patients).
- Manifest diabetes showed a strong protective effect against keratoconus (odds ratio = 0.2195, P = 0.034).
- This protective effect was specifically noted in patients with type II diabetes.
Conclusions:
- Manifest diabetes may offer protection against keratoconus development, potentially due to increased stromal cross-linking.
- The findings suggest that biomechanical alterations in the cornea can have epidemiological significance.
- Type II diabetes is associated with a reduced risk of keratoconus.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
01:20Pathophysiology of Diabetes
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
01:15Diabetes: Symptoms, Diagnosis, and Complications
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...
01:26Diabetes Mellitus: Introduction
Diabetes mellitus consists of chronic metabolic disorders characterized by persistent hyperglycemia. This elevated blood glucose results from defects in insulin secretion, impaired insulin action, or both. Insulin, produced by pancreatic β-cells, is essential for maintaining glucose homeostasis by facilitating cellular glucose uptake for energy or storage. Disruptions in insulin production or function lead to glucose accumulation in the bloodstream, causing the clinical features and long-term...
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:27Diabetic Retinopathy
DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...