Worsening glucose status associated with nerve damage in the eye
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Worse glucose status and higher glycemia levels, even at the prediabetes stage, are associated with corneal nerve damage, according to findings presented at the European Association for the Study of Diabetes annual meeting.
“Neurodegeneration in diabetes is a hormone complication. There are two types of neurodegeneration: peripheral neurodegeneration like in cases of diabetic neuropathy and can be observed by skin biopsy; central neurodegeneration like in cases of dementia and could be observed by MRI,” Sara B. A. Mokhtar, a PhD student in the department of internal medicine at Maastricht University Medical Center and the CARIM School for Cardiovascular Diseases, Maastricht, the Netherlands, said during a presentation. “However, those procedures are very complicated and time-consuming. For that, via the eye, we can observe a neurodegeneration, and we used a tool that is less complicated, precise, relatively less expensive and noninvasive.”
For the population-based, cross-sectional study, the researchers used data from the Maastricht Study on 3,471 participants (48.4% men) aged 40 to 75 years in the Maastricht area of the Netherlands. Researchers included measures of glycemia, fasting plasma glucose, HbA1c, 2-hour post-load glucose and duration of diabetes, and they categorized participants into three groups according to glucose status: normal glucose status (64.3%), prediabetes (14.7%) and type 2 diabetes (21%).
Researchers evaluated associations between glucose status and glycemic measures after adjusting for demographics, cardiovascular risks and lifestyle factors.
More adverse glucose status was associated with worse corneal nerve measures among the prediabetes group (–0.08; 95% CI, –0.17 to 0.03) and the type 2 diabetes group (–0.14; 95% CI, –0.25 to –0.04) compared with the normal glucose metabolism group. In addition, measures of glycemia were all continuously associated with corneal neurodegeneration: FPG (–0.09; 95% CI, –0.13 to –0.05), 2-hour post-load glucose (–0.07; 95% CI, –0.11 to –0.03), HbA1c (–0.08; 95% CI, –0.11 to –0.04), skin autofluorescence (–0.05; 95% CI, –0.08 to –0.01) and diabetes duration (–0.09; 95% CI, –0.17 to –0).
“We can conclude that adverse glucose metabolism status was associated with worse corneal nerve measures. That applies also that the corneal nerve measures is a process that starts before the onset of type 2 diabetes and, as we showed, in prediabetes,” Mokhtar said. “And, also, greater measures of glycemia were associated continuously with worse corneal nerve measures.”
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Mokhtar SBA, et al. Abstract #155. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 19-23, 2022; Stockholm (hybrid meeting).
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