Glycemic control and lens transparency in patients with type 1 diabetes mellitus

• Published in: American journal of ophthalmology Vol. 131; no. 3; pp. 301 - 304
• Main Authors: Kato, Satoshi, Shiokawa, Azusa, Fukushima, Harumi, Numaga, Jiro, Kitano, Shigehiko, Hori, Sadao, Kaiya, Tadayoshi, Oshika, Tetsuro
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2001; Elsevier
• Subjects: Adult; Associated diseases and complications; Biological and medical sciences; Blood Glucose - physiology; Cataract - physiopathology; Diabetes Mellitus, Type 1 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic Retinopathy - physiopathology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Hyperglycemia - physiopathology; Lens, Crystalline - physiopathology; Male; Medical sciences; Visual Acuity; Endocrinopathy; Human; Immunopathology; Cataract; Transparency; Pathophysiology; Autoimmune disease; Eye disease; Hyperglycemia; Lens disease; Insulin dependent diabetes; Lens; Anterior segment disease
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(00)00804-7

PURPOSE: To assess quantitatively the cumulative effect of hyperglycemia on lens transparency in patients with juvenile type 1 diabetes mellitus.
METHODS: Subjects were 30 patients (30 eyes) with type 1 diabetes mellitus who had well-documented records on the duration of diabetes mellitus and condition of glycemic control from the onset. They were 35 years of age or younger (mean, 26.0 years), had a history of type 1 diabetes mellitus at least 5 years (mean, 8.4 years), had corrected visual acuity of 20/20 or better, and showed no clinically apparent cataract on slit-lamp examination. Twenty-one eyes of 21 subjects served as age-matched normal controls. They were 35 years of age or younger (mean, 25.7 years), had no diabetes mellitus, had corrected visual acuity of 20/20 or better, and showed no signs of cataract on slit-lamp examination. The degree of lens opacity was quantified using the anterior eye segment analysis system based on the Scheimpflug principle. An index was created to represent the cumulative effect of long-term glycemic control (hyperglycemic accumulation) by multiplying the average hemoglobin A
1c value and the number of months from the onset.
RESULTS: The patients with diabetes mellitus exhibited significantly greater degree of lens opacity than the normal controls (
P = .017, Mann-Whitney U-test). Among the patients with diabetes mellitus, the lens opacity was greater in eyes with retinopathy than those without retinopathy (
P = .011). Multiple regression analysis revealed that only the index of hyperglycemic accumulation significantly correlated with the degree of lens opacity (
P = .042).
CONCLUSION: Accumulated effect of hyperglycemia is related to the lens transparency in patients with diabetes.