Study On Relationship Between Type 2 Diabetes Mellitus And Dry Eye

Objective:To compare the prevalence of dry eye between type 2 diabetes patients and healthy controls,and further observe the influence of the course of diabetes and glycated hemoglobin levels on tear film function,corneal epithelial condition and meibomian gland condition,etc.Methods:A total of 100 type 2 diabetic patients(200 eyes)receiving treatment in the Department of Endocrinology,Qilu Hospital of Shandong University from July 2021 to October 2021 were enrolled as the observation group,and a total of 60 healthy people(120 eyes)who were hospitalized in the Department of Ophthalmology,Qilu Hospital of Shandong University in the same period were enrolled as the control group.Demographic characteristics including gender,age,and occupation,were collected from the two groups.The prevalence of dry eye of diabetic group and the control group was analyzed.Differences in ocular surface disease index(OSDI)score,tear secretion test(SIt),break-up time(BUT)of the tear film,corneal fluorescein staining(FS),and palpebral margin,as well as meibomian gland function between the two groups were observed.The independent risk factors for dry eye syndrome in diabetic patients were analyzed,including age,course of diabetes mellitus,HbA1c level,and duration of visual display terminal use.The diabetic group was further divided into short,medium and long course groups according to the course of disease,and good or poor blood glucose control group according to concentration of HbA1c.The influence of the course of disease and HbA1c level on the prevalence of dry eye and related examination results were evaluated.Results:There was no statistical difference in the demographic characteristics of the two groups(p>0.05).In the diabetic group,57 cases(57%)suffered from dry eye,and 43 cases(43%)showed no signs of dry eye.In the control group,there were 19 cases(31.67%)with dry eye and 41 cases(68.33%)without dry eye.The prevalence of dry eye in diabetic group was significantly higher than that of control group,and there was statistical difference between the two groups(x2=9.651,p=0.002).The OSDI score of the diabetic group was higher than that of the control group,but the difference was not statistically significant(p=0.066).The SIt and BUT values of diabetic patients were lower than those of control group,and the score of meibomian gland was higher than the latter,which indicated that the tear secretion significantly reduced,all with statistical significance(p=0.001;p<0.001;p<0.001).Compared with the control group,FS score in the diabetic group increased,but the difference was not statistically significant(p=0.088).Multivariate Logistic regression analysis showed that the risk of dry eye increased with age,and the difference was statistically significant(OR=1.051,p=0.046).What’s more,the course of diabetes mellitus and the level of HbAlc were independent risk factors for dry eye in diabetic patients(OR=3.379,95%CI,1.547-7.377,p=0.002;OR=3.340,95%CI,1.173-9.510,p=0.024);In this study,there was no significant statistical difference in the impact of visual display terminal on the prevalence of dry eye in diabetic patients(p=0.331).Tear secretion were 12.72±4.52 mm,7.96±5.35 mm and 5.85±4.25 mm in short,medium and long course group(H=38.936,p<0.001).BUT were 20.43±7.77 s,9.76±6.75 s and 8.23±5.86 s,respectively(H=50.462,p<0.001).FS scores were 0.06±0.33,0.04±0.25 and 0.22±0.70 points(H=3.728,p=0.155).The scores of the meibomian gland were 0.08±0.28,0.24±0.48,0.22±0.47 points(H=3.346,p=0.188).The average SIt values of the well-controlled group and poorly controlled group were 8.46±4.57 mm and 7.87±5.63 mm,respectively.BUT were 11.43±6.72 s and 11.00±8.39 s.But there were no statistical differences neither(p=0.223,p=0.401).FS scores were 0 and 0.15±0.57,respectively,the difference was statistically significant(p=0.039).The scores of meibomian gland were 0.17±0.37,0.22±0.48 points without statistical difference(p=0.633).Conclusions:Type 2 diabetes is associated with an increased risk of dry eye,resulting in reduced tear secretion,decreased tear film stability,and corneal neuropathy.The age,the course of diabetes and HbAlc level are independent risk factors for the occurrence of dry eye in diabetic patients.With the extension of the course of diabetes and the increase of HbAlc concentration,related examinations reflecting the condition of ocular surface such as SIt and BUT decrease,but FS and the meibomian gland scores increase.