open access

Vol 6, No 1 (2017)
Original articles (submitted)
Published online: 2017-06-20
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The evaluation of ocular changes in prediabetic individuals

Anna Sokołowska-Oracz, Paweł Piątkiewicz
DOI: 10.5603/DK.2017.0003
·
Pubmed: 12376491
·
Clinical Diabetology 2017;6(1):8-16.

open access

Vol 6, No 1 (2017)
Original articles (submitted)
Published online: 2017-06-20

Abstract

Background. Prediabetes is the major risk factor for type 2 diabetes, but the prediabetic state itself is also associated with classical macrovascular and microvascular complications. Studies indicate that other ocular abnormalities can develop during the stage of prediabetes; however, data on the occurrence of ocular changes are limited. The aim of our study was to evaluate ocular changes in prediabetic individuals.

Material and methods. Sixty subjects (40 women, 20 men) aged 37–78, with impaired fasting glucose and/or impaired glucose tolerance, were enrolled in the study and compared with 30 volunteers (20 women, 10 men) without prediabetes, aged 39–75. Both groups of patients underwent a complete physical examination, biochemical tests and ophthalmic examination: visual acuity testing, colour vision and letter contrast sensitivity tests, anterior and posterior segment evalua­tion, intraocular pressure measurement, fundus photographs and optical coherence tomography. Prediabetic patients underwent examinations twice: on the 1st visit and on the 2nd visit after 9-month period.

Results. Ophthalmic examination revealed in prediabetic individuals as compared to healthy controls increased prevalence of cataract (31.67% vs. 6.67%; p < 0.05), corneal surface disorders (21.67% vs. 3.33%; p < 0.05), posterior vitreous detachments (76.67% vs. 55%; p < 0.05), arterial narrowing (81.67% vs. 63.33%; p < 0.05) and hypertension angiopathy (70% vs. 36.67%; p < 0.05). There were also differences between prediabetic and control groups in prevalence rate of retinopathy (8.33% vs. 3.33%; NS) and acquired colour vision impairment (8.33% vs. 0%, NS). When compared visit 1 to visit 2, statistically significant differences were observed in fasting plasma glucose level (106.9 vs. 104.1 mg/dL; p < 0.05) and HbA1c (5.80% vs. 5.99%; p < 0.05). There were no statistically significant differences in ocular changes; however, increased prevalence of retinopathy signs was noted during the examination after 9-month period (8.33% vs. 12.73%; NS).

Conclusion. Prediabetic subjects present increased prevalence of ocular disorders as compared to healthy population. Results of this study indicate that prediabetic state is the independent risk factor of these complications; although, many patients with prediabetes have other features of metabolic syndrome. The regular ophthalmic monitoring seems to be essential at the stage of prediabetes in order to detect ocular abnormalities and identify individuals at risk of other diabetic complications.

Abstract

Background. Prediabetes is the major risk factor for type 2 diabetes, but the prediabetic state itself is also associated with classical macrovascular and microvascular complications. Studies indicate that other ocular abnormalities can develop during the stage of prediabetes; however, data on the occurrence of ocular changes are limited. The aim of our study was to evaluate ocular changes in prediabetic individuals.

Material and methods. Sixty subjects (40 women, 20 men) aged 37–78, with impaired fasting glucose and/or impaired glucose tolerance, were enrolled in the study and compared with 30 volunteers (20 women, 10 men) without prediabetes, aged 39–75. Both groups of patients underwent a complete physical examination, biochemical tests and ophthalmic examination: visual acuity testing, colour vision and letter contrast sensitivity tests, anterior and posterior segment evalua­tion, intraocular pressure measurement, fundus photographs and optical coherence tomography. Prediabetic patients underwent examinations twice: on the 1st visit and on the 2nd visit after 9-month period.

Results. Ophthalmic examination revealed in prediabetic individuals as compared to healthy controls increased prevalence of cataract (31.67% vs. 6.67%; p < 0.05), corneal surface disorders (21.67% vs. 3.33%; p < 0.05), posterior vitreous detachments (76.67% vs. 55%; p < 0.05), arterial narrowing (81.67% vs. 63.33%; p < 0.05) and hypertension angiopathy (70% vs. 36.67%; p < 0.05). There were also differences between prediabetic and control groups in prevalence rate of retinopathy (8.33% vs. 3.33%; NS) and acquired colour vision impairment (8.33% vs. 0%, NS). When compared visit 1 to visit 2, statistically significant differences were observed in fasting plasma glucose level (106.9 vs. 104.1 mg/dL; p < 0.05) and HbA1c (5.80% vs. 5.99%; p < 0.05). There were no statistically significant differences in ocular changes; however, increased prevalence of retinopathy signs was noted during the examination after 9-month period (8.33% vs. 12.73%; NS).

Conclusion. Prediabetic subjects present increased prevalence of ocular disorders as compared to healthy population. Results of this study indicate that prediabetic state is the independent risk factor of these complications; although, many patients with prediabetes have other features of metabolic syndrome. The regular ophthalmic monitoring seems to be essential at the stage of prediabetes in order to detect ocular abnormalities and identify individuals at risk of other diabetic complications.

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Keywords

impaired fasting glucose, impaired glucose tolerance, prediabetic complications, retinopathy, posterior vitreous detachment, colour vision, diabetic cataract

About this article
Title

The evaluation of ocular changes in prediabetic individuals

Journal

Clinical Diabetology

Issue

Vol 6, No 1 (2017)

Pages

8-16

Published online

2017-06-20

DOI

10.5603/DK.2017.0003

Pubmed

12376491

Bibliographic record

Clinical Diabetology 2017;6(1):8-16.

Keywords

impaired fasting glucose
impaired glucose tolerance
prediabetic complications
retinopathy
posterior vitreous detachment
colour vision
diabetic cataract

Authors

Anna Sokołowska-Oracz
Paweł Piątkiewicz

References (19)
  1. Piątkiewicz P. Cukrzyca. Aspekty prawne i społeczne. Via Medica, Gdańsk 2016: 4–8.
  2. Brannick B, Wynn A, Dagogo-Jack S. Prediabetes as a toxic environment for the initiation of microvascular and macrovascular complications. Exp Biol Med (Maywood). 2016; 241(12): 1323–1331.
  3. Tabák AG, Herder C, Rathmann W, et al. Prediabetes: a high-risk state for diabetes development. Lancet. 2012; 379(9833): 2279–2290.
  4. Huang Y, Cai X, Mai W, et al. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ. 2016; 355: i5953.
  5. Wilczyński M, Borucka A. Powikłania okulistyczne cukrzycy. Okulistyka. Okulistyka. 2008; 3(3): 1–27.
  6. Mirkiewicz-Sieradzka B. Cukrzycowa choroba oczu. In: Sieradzki J. ed. Cukrzyca. Via Medica, Gdańsk : 569–596.
  7. Lamparter J, Raum P, Pfeiffer N, et al. Prevalence and associations of diabetic retinopathy in a large cohort of prediabetic subjects: the Gutenberg Health Study. J Diabetes Complications. 2014; 28(4): 482–487.
  8. Diabetes Prevention Program Research Group. The prevalence of retinopathy in impaired glucose tolerance and recent-onset diabetes in the Diabetes Prevention Program. Diabet Med. 2007; 24(2): 137–144.
  9. Tyrberg M, Melander A, Lövestam-Adrian M, et al. Retinopathy in subjects with impaired fasting glucose: the NANSY-Eye baseline report. Diabetes Obes Metab. 2008; 10(8): 646–651.
  10. Pang C, Jia L, Jiang S, et al. Determination of diabetic retinopathy prevalence and associated risk factors in Chinese diabetic and pre-diabetic subjects: Shanghai diabetic complications study. Diabetes Metab Res Rev. 2012; 28(3): 276–283.
  11. Regillo C, Chang TS, Johnson MW. Basic and Clinical Science Course. Część 12 – Siatkówka i ciało szkliste.Wydanie I polskie pod redakcją Krystyny Pecold. Elsevier Urban & Partner, Wrocław 2007: 280–282.
  12. Liu L, Yue S, Wu J, et al. The Prevalence and Distribution of Vitreoretinal Interface Abnormalities among Urban Community Population in China. J Ophthalmol. 2015; 2015: 742686.
  13. Gella L, Raman R, Pal SS, et al. Incidence, Progression, and Associated Risk Factors of Posterior Vitreous Detachment in Type 2 Diabetes Mellitus: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study. . Semin Ophthalmol. 2015; 19: 1–7.
  14. Aung KZ, Makeyeva G, Adams MK, et al. The prevalence and risk factors of epiretinal membranes: the Melbourne Collaborative Cohort Study. Retina. 2013; 33(5): 1026–1034.
  15. Wylęgała E, Nowińska A, Teper S. Optyczna koherentna tomografia. Tom II. Bedeker Okulistyczny. Górnicki Wydawnictwo Medyczne, Wrocław 2011: 81–85.
  16. Stopyra W. Widzenie barw.Okulistyka – Program Edukacyjny Kompendium Okulistyki. 2012; 19(3): 1–18.
  17. Malukiewicz G, Lesiewska-Junk H, Kaźmierczak K. Zaburzenia widzenia barwnego i wrażliwości na kontrast u chorych z cukrzycą typu II bez cech retinopatii. Klin Oczna. 2009; 111: 221–223.
  18. Shoji T, Sakurai Y, Sato H, et al. Do type 2 diabetes patients without diabetic retinopathy or subjects with impaired fasting glucose have impaired colour vision? The Okubo Color Study Report. Diabet Med. 2011; 28(7): 865–871.
  19. Karadeniz S, Kir N, Yilmaz MT, et al. Alteration of visual function in impaired glucose tolerance. Eur J Ophthalmol. 1996; 6(1): 59–62.

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