Diabetes mellitus in primary glaucomas

Area of Science:

• Ophthalmology
• Endocrinology
• Public Health

Background:

• Primary glaucomas represent a significant cause of irreversible blindness worldwide.
• Diabetes mellitus is a prevalent systemic disease with numerous microvascular and macrovascular complications.
• The relationship between diabetes and different types of primary glaucoma requires clarification.

Purpose of the Study:

• To investigate the specific associations between diabetes mellitus and various subtypes of primary glaucoma.
• To determine if the type of diabetes (insulin-dependent vs. non-insulin-dependent) influences glaucoma risk.
• To explore the role of impaired glucose tolerance in the development of primary glaucoma.

Main Methods:

• Retrospective analysis of diabetic family history.
• Prospective follow-up of patients with primary glaucoma.
• 75-gram oral glucose tolerance testing (OGTT).
• Estimation of glycosylated hemoglobin (HbA1c).

Main Results:

• Diabetes mellitus showed a significant association with narrow-angle glaucoma, including closed-angle glaucoma and narrow-angle with ocular hypertension or open-angle glaucoma.
• No significant difference in the prevalence of diabetes mellitus was observed in patients with wide-angle glaucoma compared to controls.
• The association was specific to non-insulin-dependent diabetes mellitus and impaired glucose tolerance; insulin-dependent diabetes mellitus prevalence was similar to controls.

Conclusions:

• The link between diabetes and primary glaucoma is primarily confined to narrow-angle subtypes.
• Non-insulin-dependent diabetes mellitus and impaired glucose tolerance are key factors in this association.
• Insulin-dependent diabetes mellitus does not appear to increase the risk for primary glaucomas.