Diabetes Drugs Linked With Lower Risks of Open-Angle Glaucoma, AMD

New research revealed in JAMA Ophthalmology evaluating the url in between prevalent eye ailments and diabetes exposed that in a inhabitants of European ethnicity, diabetes was associated with cataract growth, but diabetes medicine was not.

Additionally, therapy with metformin was connected with a reduce danger of open up-angle glaucoma (OAG) even though other diabetes medications were affiliated with a decreased risk of age-relevant macular degeneration (AMD), authors wrote.

Nonetheless, interventional clinical trials are expected to figure out evidence of benefit for these prescription drugs.

Together, OAG, AMD, and cataracts are the main results in of blindness all-around the entire world and account for about 65% of blindness in grown ups over the age of 50. Around the subsequent 2 many years, prevalence of OAG and AMD is envisioned to maximize together with gains in lifetime expectancy, researchers spelled out.

Past research has recommended a opportunity protecting outcome of metformin on OAG and AMD with mechanisms showing up independent of glucose-lowering effects.

To improved elucidate the association among metformin, insulin, and sulfonylurea derivatives with OAG, AMD and cataracts, investigators assessed data from the future Rotterdam Analyze. To examine likely comorbidity, they also appeared at backlinks among untreated variety 2 diabetes (T2D) and the 3 eye situations.

Rotterdam analyze enrollment took position involving April 1990 and June 2014 and contributors underwent each baseline examinations and 5-12 months abide by-up visits. Of the 14,926 members, a full of 11,260 were being involved in the existing examination, all of whom underwent ophthalmologic exams, experienced measurements of serum-glucose carried out at baseline, continual treatment monitoring, and concluded at least 1 abide by-up take a look at.

“Medication facts have been received from 7 completely automatic pharmacies making use of a centralized computer system network in the analyze district from January 1, 1991, onward,” authors wrote.

Indicate (SD) patient age was 65.1 (9.8) several years when 58.7% of the cohort had been women. The Rotterdam research was based mostly in The Netherlands and 98% of members were being of European ancestry. Just about 30% of contributors were being diagnosed with T2D (28.4%), 4.4% had been identified with OAG, 17.6% with AMD, and 37.3% with cataract.

Analyses discovered:

• Untreated T2D was affiliated with a better risk of OAG (odds ratio [OR], 1.50 95% CI, 1.06-2.13 P  =  .02), AMD (OR, 1.35 95% CI, 1.11-1.64 P  =  .003), and cataract (OR, 1.63 95% CI, 1.39-1.92 P  < .001)
• T2D treated with metformin was associated with a lower risk of OAG (OR, 0.18 95% CI, 0.08-0.41 P  < .001)
• Other diabetes medication (ie, insulin, sulfonylurea derivates) was associated with a lower risk of AMD (combined OR, 0.32 95% CI, 0.18 to 0.55 P  < .001)
• The cumulative lifetime risk of OAG was lower for individuals taking metformin (1.5% 95% CI, 0.01%-3.1%) than for individuals without T2D (7.2% 95% CI, 5.7%-8.7%)
• The lifetime risk of AMD was lower for individuals taking other diabetes medication (17.0% 95% CI, 5.8%-26.8% vs 33.1% 95% CI, 30.6%-35.6%)

Overall, “metformin had the strongest inverse association with OAG followed by AMD but was not associated with cataract,” authors wrote.

While the study’s prospective population-based design and large sample population mark strengths, residual confounding may have been present and a low number of patients with OAG was assessed.

However, the magnitude of associations seen warrants interventional clinical trials, researchers concluded.

Reference

Vergroesen JE, Thee EF, Ahmadizar F, et al. Association of diabetes medication with open-angle glaucoma, age-related macular degeneration, and cataract in the Rotterdam study. JAMA Ophthalmol. Published online May 19, 2022. doi: 10.1001/jamaophthalmol.2022.1435