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Glycemic control and lens transparency in patients with type 1 diabetes mellitus
S Kato1, A Shiokawa, H Fukushima
1Department of Ophthalmology, School of Medicine, University of Tokyo, 3-28-5 Mejirodai, Bunkyo-ku, Tokyo, 112-8688 Japan. katou-s@ka2.so-net.ne.jp
Insights
High blood sugar over time significantly increases lens cloudiness in type 1 diabetes patients. This cumulative hyperglycemia effect impacts lens transparency, especially in those with retinopathy.
Area of Science:
- Ophthalmology
- Endocrinology
- Diabetology
Background:
- Type 1 diabetes mellitus is a chronic condition requiring careful glycemic management.
- Long-term hyperglycemia is a known risk factor for various diabetic complications.
- Lens transparency can be affected by metabolic changes associated with diabetes.
Purpose of the Study:
- To quantitatively assess the cumulative impact of hyperglycemia on lens transparency.
- To investigate the relationship between glycemic control duration and lens opacity in juvenile diabetes.
- To establish a correlation between hyperglycemic accumulation and the degree of lens opacity.
Main Methods:
- Quantified lens opacity using an anterior eye segment analysis system (Scheimpflug principle).
- Created a hyperglycemic accumulation index (average HbA1c x months from onset).
- Compared lens opacity in 30 type 1 diabetes patients (≤35 years) with 21 age-matched controls.
Main Results:
- Patients with diabetes showed significantly greater lens opacity than controls (P=.017).
- Lens opacity was more pronounced in diabetic eyes with retinopathy (P=.011).
- Hyperglycemic accumulation index strongly correlated with lens opacity (P=.042).
Conclusions:
- The cumulative effect of hyperglycemia is significantly associated with reduced lens transparency in type 1 diabetes.
- Long-term glycemic control is a critical factor influencing lens health in diabetic patients.
- This study highlights the detrimental impact of sustained high blood sugar on ocular health.
Purpose:
To assess quantitatively the cumulative effect of hyperglycemia on lens transparency in patients with juvenile type 1 diabetes mellitus.
Methods:
Subjects were 30 patients (30 eyes) with type 1 diabetes mellitus who had well-documented records on the duration of diabetes mellitus and condition of glycemic control from the onset. They were 35 years of age or younger (mean, 26.0 years), had a history of type 1 diabetes mellitus at least 5 years (mean, 8.4 years), had corrected visual acuity of 20/20 or better, and showed no clinically apparent cataract on slit-lamp examination. Twenty-one eyes of 21 subjects served as age-matched normal controls. They were 35 years of age or younger (mean, 25.7 years), had no diabetes mellitus, had corrected visual acuity of 20/20 or better, and showed no signs of cataract on slit-lamp examination. The degree of lens opacity was quantified using the anterior eye segment analysis system based on the Scheimpflug principle. An index was created to represent the cumulative effect of long-term glycemic control (hyperglycemic accumulation) by multiplying the average hemoglobin A(1c) value and the number of months from the onset.
Results:
The patients with diabetes mellitus exhibited significantly greater degree of lens opacity than the normal controls (P =.017, Mann-Whitney U-test). Among the patients with diabetes mellitus, the lens opacity was greater in eyes with retinopathy than those without retinopathy (P =.011). Multiple regression analysis revealed that only the index of hyperglycemic accumulation significantly correlated with the degree of lens opacity (P =.042).
Conclusion:
Accumulated effect of hyperglycemia is related to the lens transparency in patients with diabetes.