GLP-1R Agonists Improve Ocular Surface Parameters in Type 2 Diabetes Mellitus
Giovanni Ottonelli1, Alessandro Gaeta2, Novella Montericcio3
1Department of Ophthalmology, IRCCS Humanitas Research Hospital, Milan, 20089, Italy.
Clinical Ophthalmology (Auckland, N.Z.)
|October 21, 2025
Summary
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve tear production and tear film stability in type 2 diabetes patients. This suggests GLP-1 RAs may protect ocular surface health in this population.
Area of Science:
- Ophthalmology
- Endocrinology
- Diabetology
Background:
- Dry eye disease (DED) is common in type 2 diabetes mellitus (T2DM).
- Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) offer systemic anti-inflammatory and vascular benefits.
- The impact of GLP-1 RAs on tear film parameters in T2DM patients is not well understood.
Purpose of the Study:
- To investigate the effects of GLP-1 RAs on ocular surface health in patients with T2DM.
- To evaluate changes in tear film parameters associated with GLP-1 RA use.
Main Methods:
- A single-center case-control study included 35 T2DM patients on glucose-lowering therapies.
- Patients were grouped based on GLP-1 RA use (n=21) versus non-GLP-1 RA use (n=14).
- Ocular surface parameters, including Schirmer I test and tear breakup time (TBUT), were assessed.
Main Results:
- GLP-1 RA users showed significantly higher Schirmer I test values (15 mm vs. 7.5 mm; p=0.016).
- Tear breakup time (TBUT) was significantly longer in the GLP-1 RA group (10 sec vs. 5.85 sec; p<0.01).
- Subgroup analysis indicated significant differences in tear production based on specific antidiabetic therapies.
Conclusions:
- GLP-1 RA therapy is linked to enhanced tear production and tear film stability in T2DM patients.
- These findings suggest a potential protective role for GLP-1 RAs on the ocular surface.
- Larger prospective studies are needed to confirm these results and explore mechanisms.
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