DPP-IV, SGLT2 and GLP-1 drugs do not increase risk for diabetic macular edema
Click Here to Manage Email Alerts
Key takeaways:
- Adults with type 2 diabetes did not have higher risk for diabetic macular edema if they used one of three classes of diabetes medication.
- More research is needed to assess risks of adults with higher baseline HbA1c.
Use of a DPP-IV inhibitor, SGLT2 inhibitor or GLP-1 receptor agonist does not increase risk for diabetic macular edema among adults with type 2 diabetes and diabetic retinopathy, according to study data.
Researchers assessed diabetic macular edema risk among adults using one of three classes of diabetes medication as well as adults using multiple classes of medication in a retrospective study published in Journal of Diabetes and Its Complications. None of the medications were associated with higher risk for diabetic macular edema, though adults who had a higher HbA1c and a shorter duration of proliferative diabetic retinopathy were more likely to develop the disorder.
“As long as patients are getting regular eye exams and monitoring of their diabetic eye diseases, it does not seem like these medications worsen the risk of developing macular edema,” Roomasa Channa, MD, assistant professor of ophthalmology at University of Wisconsin School of Medicine and Public Health, told Healio.
Channa and colleagues analyzed data from adults with type 2 diabetes plus diabetic retinopathy who attended the University of Wisconsin Eye Clinic from 2010 to May 2022. Diabetic macular edema diagnoses and the use of medications were obtained from medical records. Separate analyses were performed for each class of medication as well as for adults using multiple medications.
There were 963 adults included in the DPP-IV analysis, of which 13.8% developed diabetic macular edema. Of the group, 9.6% had proliferative diabetic retinopathy. Adults using a DPP-IV inhibitor had a similar risk for diabetic macular edema as those not using a DPP-IV.
Of 957 adults in the GLP-1 analysis, 13.6% developed diabetic macular edema. Proliferative diabetic retinopathy was observed in 10% of the group. Adults using a GLP-1 receptor agonist had no difference in diabetic macular edema risk compared with those not using a GLP-1.
The SGLT2 inhibitor analysis included 879 adults, of whom 13.2% were diagnosed with diabetic macular edema and 9.9% had proliferative diabetic retinopathy. No difference in diabetic macular edema risk was observed for adults using an SGLT2 inhibitor and those not using an SGLT2.
There were 1,117 adults in the multiple medication analysis. Of the group, 14.6% developed diabetic macular edema. The risk for diabetic macular edema was similar for adults using any one medication and those using two or more medications compared with those not using a medication.
Channa said the findings were not surprising as the mean HbA1c in each analysis was either 7.6% or 7.7%.
“We need to do a similar study on a more diverse population with varying levels of glycemic control,” Channa said.
Adults who had proliferative diabetic retinopathy for less than 6 years were more likely to develop diabetic macular edema than those who did not have proliferative diabetic retinopathy (HR = 3.6; 95% CI, 2.4-5.6; P < .001). Each 1 U increase in mean HbA1c for adults with diabetic retinopathy for 1.5 to 3 years (HR = 1.2; 95% CI, 1-1.4; P = .02) and those with diabetic retinopathy for more than 3 years (HR = 1.4; 95% CI, 1.2-1.7; P < .001) raised the risk for diabetic macular edema.
For more information:
Roomasa Channa, MD, can be reached at rchanna@wisc.edu.
Collapse
Click Here to Manage Email Alerts