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ORIGINAL ARTICLE
Year : 2022  |  Volume : 60  |  Issue : 4  |  Page : 294-300

Association of intraocular pressure with blood sugar levels in patients of type 2 diabetes mellitus and control group


1 Department of Ophthalmology, Government Doon Medical College, Dehradun, Uttarakhand, India
2 Department of Ophthalmology, Heritage Institute of Medical Sceinces, Varanasi, Uttar Pradesh, India

Correspondence Address:
Sushil Ojha
Government Doon Medical College Dehradun, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_38_22

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Introduction: Glaucoma is a progressive optic neuropathy associated with loss of retinal ganglion cells, visual field loss and may or may not be associated with raised intraocular pressure (IOP). Although glaucoma is a multifactorial disease, elevated IOP remains the only modifiable risk factor. The direct relationship between IOP increase and decrease in retinal nerve fiber layer thickness has already been established by various authors previously. Hence, it is imperative to control the IOP to prevent the optic nerve damage and progressive visual field loss. The IOP can be influenced by various systemic factors, viz., hypertension, atherosclerotic diseases, body mass index (BMI), and diabetes mellitus (DM). Methodology: This study was conducted in a tertiary care center located in hilly areas of Northern India. Patients were recruited from out patient department (OPD). Design: Prospective, cross-sectional and case-control study. Sample: Patients attending medicine and ophthalmology OPD in Government Doon Medical College Hospital, Dehradun, were included in the study. Subjects were recruited as per selection criteria. This study included 25 patients with type 2 DM and 25 patients with the control group. Inclusion criteria (Group 1:Diabetic patients):
  • Patients with diagnosed type 2 DM.
Inclusion criteria (Group 2: Non-diabetic patients):
  • Healthy subjects without any history of raised blood sugar levels in the last 2 years.
Exclusion criteria:
  • Diagnosed cases of glaucoma,
  • Diagnosed ocular hypertension,
  • Patients with corneal opacity, posterior segment diseases, or non-cooperative for eye examination,
  • Refractive error greater than ± 5D spherical, or cylindrical refractive error greater than ± 2.5D.
Capillary glucose testing: IOP assessment: Immediately after the capillary glucose testing, IOP was measured in both eyes (i.e., fasting for exactly 10 hour and exactly 2 after breakfast) of each patient by Goldmann applanation tonometry. All readings were taken with the patient in a sitting position. Statistical analysis:All statistical analyses were performed with Statistical Package for Social Sciences version 21.0. Conclusion: We can conclude a significant relationship between glucose variation and IOP variation in the diabetic group with our results. The diabetic group exhibited higher values of fasting and post-prandial measurements than the control group. Hence, we recommend blood glucose testing in diabetic patients with glaucoma simultaneously with IOP monitoring. It should also include good blood sugar control. Though we are limited by a small sample size and time limit. A longitudinal study will help to get better and clearer results.


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