Dry Eye Disease in Type II Diabetes and its Association with Antidiabetic Medication

Context: Diabetic mellitus (DM) is a multifactorial disease that increases the risk for the development of dry eye, refractive error, cataract, glaucoma, and retinopathy. Chronic hyperglycemia and decreased insulin levels lead to lacrimal dysfunction, change in tear osmolarity, and tear film instability causing dry eye. It can also induce loss of pericyte in retinal capillaries, causing retinopathy and subsequent vision loss. Aims: To determine the prevalence of dry eyes in diabetes and control and its association with glycosylated haemoglobin (HbA1c) and hypoglycaemic agents. Settings and Design: Case–control study. Methods and Material: This is a case–control study that included 1:1 type II DM (135) and age-matched controls (135). They were subjected to detailed ocular and medical history. Anterior and dilated posterior segment examinations were performed. Dry eye assessment was performed using Schirmer, tear film breakup time (TBUT), and tear meniscus height. Fasting, postprandial blood sugar, and HbA1c were assessed. Statistical Analysis Used: Student’s t -test was used for comparisons between the groups. Association between variables was detected using the Chi-square test. Statistical significance was set at P <0.05. Results: The mean age is 56 ± 10.73 years (32–87 years, and females outnumbered males ( n = 144;53.3%). Diabetic retinopathy was observed in 29 participants (21.5%), and the duration of DM was less than 5 years in 64 participants (47.4%). Metformin users were more ( n = 46; 34.1%) compared to other hypoglycemics. Schirmer test, TBUT, and tear meniscus height showed a significant association with DM, retinopathy, HbA1c, and hypoglycaemic agents ( P < 0.05). Conclusions: Dry eye was observed in 55.2% of DM patients and 37.7% of controls.