The Effects of Type 2 Diabetes Mellitus on Meibomian Gland Morphology and Tear Film Parameters: Cross-Sectional Study

Objective: To evaluate the meibomian gland (MG) morphology and tear film parameters of patients with Type 2 diabetes mellitus (DM) and to compare them with healthy individuals. Material and Methods: Fifty-four eyes of 27 patients (DM group) with Type 2 DM and 50 eyes of 25 healthy individuals (control group) in terms of Ocular Surface Disease Index (OSDI) score, Schirmer's test, van Bijsterveld score (vBs), non-invasive break-up time (NiBUT) and MG morphologies (by non-contact, non-invasive infrared meibography) were evaluated and analyzed. Results: DM and control groups were similar in terms of mean age (p=0.51) and gender (p=0.78). In DM and control groups, respectively; OSDI; 15.3±3.7-11.9±2.7 (p=0.03), Schirmer; 10.3±3.4-12.5±3.2 mm (p<0.001), first NiBUT; 7.47±4.38- 10.41±4.89 sec (p=0.002), mean NiBUT; 9.6±3.7 vs. 12.3±4.0 sec (p<0.001), meibo-degree; 1.59±1.20-0.82±1.04 units (p<0.001), meibo score 31.3±22.2%-18.5±16.9% (p<0.001) and vBs; were 3.8±2.4 and 2.2±1.7 (p<0.001). In the DM group, a significant relationship was found between the presence of retinopathy and Schirmer (p<0.001), first NiBUT (p<0.001), average NiBUT (p<0.001), meibo score (p<0.001) and vBs (p<0.001). Conclusion: Type 2 DM, negatively affects MG morphology and tear film layer. Evaluation of DM patients in terms of MG dysfunction and dry eye disease as well as retinopathy during routine examinations can ensure early diagnosis of MG dysfunction and dry eye disease, initiation of appropriate treatment and protection of the ocular surface.