Diabetic Eye Conditions Predicted to Rise Significantly

Will 1 in 3 Americans have full-blown diabetes by 2050? Center for Disease Control and Prevention (CDC) director Dr. Ann Allbright warned back in 2010 that this could be the future state of America's health if current trends continue. 95% of diagnosed diabetes cases in the US are considered Type 2, which manifests gradually from a state of insulin resistance and can be prevented. Many people do not know they are insulin resistant, and testing for insulin resistance needs to be accelerated worldwide immediately.

A frightening complication of diabetes is vision loss and even blindness. The National Eye Institute predicts that from 2010 to 2050, the number of Americans with diabetic retinopathy, a serious, sight-threatening condition, will nearly double, from 7.7 million to 14.6 million. Current diabetic retinopathy treatments, including laser procedures, surgery, and injections of medication into the eye, may help to prevent complete vision loss.

I've come across a great deal of published literature discussing the importance of thiamine, or Vitamin B1, and the amino acids agmatine and taurine in preventing the development of diabetic vascular complications such as diabetic retinopathy. Nutritional yeast and Brewer's yeast are great natural forms of B1. The ketogenic diet, associated with lower carbohydrate intake, was also shown in a 2020 study to slow retinal degeneration.

Diabetics additionally have an increased risk in the development of several other adverse eye conditions, including cataracts, glaucoma and dry eye syndrome. 

The 2019 paper Cataract in Diabetes Mellitus, published in the World Journal of Diabetes, states: "Diabetes can lead to pathologies in many tissues in the eye structure...Cataract is one of the major causes of visual impairment in diabetic patients. Patients with diabetes are reported to be up to five times more likely to develop cataract, in particular at an early age. Due to the increasing prevalence of diabetes, the incidence of diabetic cataracts has also risen." The study continues that despite technological advances in cataract surgery, "poor visual acuity following cataract extraction is still common in patients with diabetes."

The 2017 study Diabetes and Risk of Glaucoma: Systematic Review and a Meta-Analysis of Prospective Cohort Studies concluded that diabetes is associated with a "significantly increased risk of glaucoma." Neovascular glaucoma is a particularly devastating version that can develop in diabetics due to poor blood flow. 

According to the 2016 study Dry Eye Syndrome in Patients with Diabetes Mellitus: Prevalence, Etiology, and Clinical Characteristics, "...diabetes has been identified as one of the leading causes of dry eye syndrome. Poor glycemic control affects both the anterior and the posterior segments of the eye and increasing prevalence of diabetes-associated dry eye syndrome has been reported in recent years." Researchers are currently exploring whether topical insulin can provide relief for diabetics with dry eye syndrome. While typically prescribed artificial tears only provide symptomatic relief, researchers are testing whether topical insulin can heal and repair the lacrimal gland, which secretes tears. Look out for my comprehensive post on how insulin is proving to be of great benefit in a wide range of ocular disease! 

There's an interesting 2002 study I have saved on my phone called Identification of Insulin in the Tear Film and Insulin Receptor and IGF-1 Receptor on the Human Ocular Surface. This study represented the first demonstration of insulin in human tear film and the presence of insulin and the IGF-1 receptor on the human ocular surface. 

Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease. The 2014 study The Combined Effect of Azithromycin and Insulin-Like Growth Factor-1 (IGF-1) on Cultured Human Meibomian Gland Epithelial Cells found that the combination of the antibiotic azithromycin and IGF-1 promotes the differentiation and lipid accumulation of human meibomian gland epithelial cells, while preserving their normal proliferation rate.

Diabetes is also being seen as a possible pre-disposer for blepharitis, or inflammation of the eyelid margins. A 2018 study out of the British Journal of Ophthalmology found "blepharitis is significantly related to metabolic syndrome and can serve as an early sign of metabolic syndrome." This could be due to demodicosis from the demodex mite, a common, often misdiagnosed infestation that diabetics and the insulin resistant are more prone to due to weakened immunity. I will be doing a separate post solely on this at a later date.