Abstract
Purpose:
To evaluate the effect of intravitreal dexamethasone implant (Ozurdex®) in the glycemic control of patients with diabetic macular edema.
Methods:
Ten patients with diabetic macular edema received an intravitreal injection (IVI) of dexamethasone implant (DEX implant, Ozurdex®). Glycated haemoglobin (HbA1C) is analyzed before and three months after IVI. The real-time glycemic readings, throughout the day and night, during at least one week, are provided by a new medical device (Animas® Vibe, Novalab, Fr).<br /> The primary outcome analysis was the comparison of HbA1C test before and after IVI. Other data included: blood glucose average, the percentage of time spent higher, lower and in glycemic target, and standard deviation over the period.
Results:
Analysis of blood glucose was performed on an average of 10 days +/-3. The level of HbA1C decreased of 0,23% after the IVI (NS). Mean blood glycemic levels are 155,6 +/- 30,3 mg/dl before IVI and 140,3 +/- 29,3 mg/dl after IVI (p>0,9999).<br /> Patients spent 69,65% of time in the glycemic target before IVI, and 79% after IVI (p>0,1). Patients spent 28,97% of time above the glycemic target before IVI and 17,83% after IVI (p>0,1). Patients spent 1,38% of time below the target before IVI and 3,17% after (p>0,1). No significant difference was found between extreme values of blood glucose after IVI: 321,6 mg/dl versus 292 mg/dl for the highest values, 62,4 mg/dl versus 61,67 mg/dl for the lower values.
Conclusions:
A bad control of diabetes is identified as a risk factor for both the development and progression of diabetic macular edema. So, it seems important that IVI of dexamethasone implant have no impact on blood glucose levels in diabetic patients. To our knowledge, this is the first study that analyses the glycemic control in human after DEX implant IVI with a daily continuous glucose monitoring.<br /> In this preliminary study, the intravitreal dexamethasone implant doesn’t seem to influence the glycemic profile in patients with diabetic macular edema. These data are also important for the endocrinologists.