The impact of glycemic control and duration of diabetes on clinical manifestation of ocular surface in middle-aged and elderly type 2 diabetic population

Abstract Purpose To investigate the impact of glycemic control and duration of diabetes on clinical manifestation of dry eye in middle-aged and elderly type 2 diabetic population of Tianjin, Northern China. Methods Participants aged over 50 years with type 2 diabetes mellitus (T2DM) were enrolled from December 2019 to August 2022. Systemic and ophthalmic examinations were performed, and diabetic status was screened. Diabetic participants were grouped according to HbA1c levels (HbA1c < 7.8% and HbA1c ≥ 7.8%). In addition, participants were divided into 3 groups according to duration of diabetes (< 10 years, 10–19 years, ≥ 20 years). Regression analyses assessed the potential risk factors. Results 1743 participants were included with a mean age of 64.10 ± 6.70 years old. 433 (24.84%) was diagnosed with dry eye disease (DED) and 1059 (60.76%) had asymptomatic DED. Women were more likely to have DED than men (P < 0.05). LLT (P = 0.020) in two HbA1c groups had statistical difference. Among different durations of diabetes, CFS (P = 0.012), MES (P = 0.001) and MQS (P = 0.045) were significantly significant. There was a statistically significant association between the history of high blood pressure (HBP) and DED (P = 0.042). Meanwhile, people with moderate insomnia had a statistically significant difference in the occurrence of dry eye (P = 0.049). Mild (P = 0.003) and moderate (P = 0.014) anxious populations were more prone to DED. Conclusions In the T2DM population, women had a larger proportion of DED than men. The meibomian gland's morphology and function degraded over time in the diabetes. Diabetics with anxiety and sleep deprivation were more likely to have dry eyes.