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L.R. Pasquale, J. Kang, W. Willett, R. Bernard, G. Colditz, S. Hankinson; Prospective Study of Type 2 Diabetes Mellitus and Risk of Primary Open–Angle Glaucoma in Women . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3522.
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Purpose: We conducted a prospective cohort analysis among women in the Nurses’ Health Study to examine the relation between type 2 diabetes mellitus and primary open–angle glaucoma (POAG). Methods: Women (n = 76 995 in the Nurses' Health Study) free of POAG in 1980, were followed until 2000 if they were ≥ 40 years old and reported receiving eye exams during follow–up. Potential confounders were assessed on biennial questionnaires, and a diagnosis of type 2 diabetes mellitus was confirmed on a validated supplemental questionnaire. We analyzed 428 self–reported POAG cases confirmed by medical chart review. Multivariate rate ratios (RRs) were obtained by using proportional hazards models. Results: After controlling for age, race, hypertension, body mass index (BMI), physical activity, alcohol intake and family history of glaucoma, type 2 diabetes mellitus was positively associated with POAG [RR=1.61 (1.06–2.42)]. Further control for systemic drugs that could alter glaucoma risk produced a nearly identical RR [RR=1.61 (1.07–2.43)]. The association was particularly robust for participants with diabetes of < 5 years duration [RR=1.89 (1.06–3.35)]. In secondary analyses, to further evaluate the potential for detection bias, we excluded cases with other conditions that cause visual field loss, such as diabetic retinopathy, and the results did not change materially. Conclusions: After controlling for factors known to enhance insulin resistance (such as BMI), type 2 diabetes was a risk factor for the development of POAG. Further studies are needed on the relation between insulin resistance, intraocular pressure and POAG.
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