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Lydia Alekseevna Mineeva, Irina Glebovna Slezkina, Leonid Balashevich, Leonid Shubin, Andrei Kabanov; A study of the dynamics of the relationship of the lens with blood glucose levels and HbA1c in patients with insulin dependent Diabetes Mellitus type 2. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2520.
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© ARVO (1962-2015); The Authors (2016-present)
We have previously shown that the normalization of blood glucose, in the development of diabetic cataract, may improve the lens NO but does not change the NC and P and does not stop the existing changes C. HbA1c is a more sensitive indicator than blood glucose, but eye structures react to it differently. The aim of this work is to study the dynamics of the relationship of the lens with blood glucose levels and HbA1c in patients with insulin dependent Diabetes Mellitus (DM) type 2 in a subcompensation phase.
Ophthalmologic monitoring lasted 3 years and insulin therapy for 6 years. A group consists of 32 patients (64 eyes): 84.4% females and 15.6% males with DM type 2 without severe complications and concomitant eye pathology at age of 60.4±5.3. The lens was estimated by LOCS III. Blood glucose level was significantly decreased, and HbA1c levels remained almost constant.
A significant negative correlation (Spearman R=-0.31; p=0.018) between glucose and NO was found only on 4th visit. With HbA1c and the lens components (nuclear opalescence (NO), nuclear color (NC), cortical cataract (C), posterior subcapsular cataract (P)), a significant correlation was found in all 4 visits. On the first visit a positive correlation was between HbA1c and C OD (R=0.27; p=0.013) and P OS (R=0.32; p=0.007) i.e. a decrease in HbA1c lead to a higher clarity of C and P. At 4-th visit a negative correlation was for NO OD (R=-0.3; p=0.021) and C OS (R=-0.33; p=0.014); reducing of HbA1c lead to a lower clarity of NO and C.
HbA1c is a marker and a trigger of possible changes in the lens in patients with DM type 2 with prolonged insulin therapy. HbA1c is more effective indicator to track changes in the eye dynamics in these patients. Changing of a positive correlation between HbA1c and C at the beginning of the study to a negative one at the end indicates to disruption of the lens compensation and does not stop the negative changes in the index C of the lens even at reducing of HbA1c.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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