Comparison of insulin resistance and lipid profile in clinically significant macular oedema versus non-clinically significant macular oedema in patients with type 2 diabetes mellitus
Lifestyle-related disorders, particularly diabetes, pose a significant global health challenge. Diabetic macular oedema, a microvascular complication, highlights the importance of managing insulin resistance and hyperlipidaemia for optimal clinical outcomes. Understanding the interplay between these factors is crucial for optimising therapeutic strategies and improving patient care. This cross-sectional study aimed to compare insulin resistance and lipid profiles between patients with clinically significant macular oedema and those with non-clinically significant macular oedema, both diagnosed with type 2 diabetes mellitus. This research can aid in the earlier identification and classification of macular oedema, enabling more timely and specific interventions. In general, 86 patients with type 2 diabetes mellitus and macular oedema were divided into two groups: clinically significant macular oedema and non-clinically significant macular oedema. Comprehensive demographic data, medical histories, and current medication regimens were recorded. Glycaemic control and lipid profiles were assessed, while ophthalmological evaluations included visual acuity measurements and intraocular pressure assessments. Significant differences were observed between the two groups, particularly in diabetes duration, body mass index, blood glucose levels, and lipid profiles. Patients with clinically significant macular oedema had a longer duration of diabetes, a higher body mass index, and elevated blood glucose levels. Triglyceride levels were significantly higher, while high‑density lipoprotein levels were lower in the clinically significant macular oedema group. Multivariate analysis revealed significant associations between the odds of developing clinically significant macular oedema and diabetes duration, visual acuity, and high-density lipoprotein levels, suggesting their potential as risk factors for this condition
diabetic macular oedema; dyslipidaemia; retinal diseases; diabetic neuropathies; retinal vein occlusion
https://doi.org/10.63341/ijmmr/1.2025.22- GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402(10397):203–34. DOI: 10.1016/S0140-6736(23)01301-6
- International Diabetes Federation (IDF) Diabetes Atlas [Internet]. [cited 2024 October 8]. Available from: https://diabetesatlas.org/atlas/tenth-edition/
- Kumar A, Gangwar R, Zargar AA, Kumar R, Sharma A. Prevalence of diabetes in India: A review of IDF Diabetes Atlas 10th edition. Curr Diabetes Rev. 2024;20(1):e130423215752. DOI: 10.2174/1573399819666230413094200
- Chan LKY, Lin SS, Chan F, Ng DS. Optimizing treatment for diabetic macular edema during cataract surgery. Front Endocrinol (Lausanne). 2023;14:1106706. DOI: 10.3389/fendo.2023.1106706
- Rao H, Jalali JA, Johnston TP, Koulen P. Emerging roles of dyslipidemia and hyperglycemia in diabetic retinopathy: Molecular mechanisms and clinical perspectives. Front Endocrinol (Lausanne). 2021;12:620045. DOI: 10.3389/fendo.2021.620045
- Park SJ, Park DH. Revisiting lipids in retinal diseases: A focused review on age-related macular degeneration and diabetic retinopathy. J Lipid Atheroscler. 2020;9(3):406–18. DOI: 10.12997/jla.2020.9.3.406
- Xu YX, Pu SD, Zhang YT, Tong XW, Sun XT, Shan YY, et al. Insulin resistance is associated with the presence and severity of retinopathy in patients with type 2 diabetes. Clin Exp Ophthalmol. 2024;52(1):63–77. DOI: 10.1111/ceo.14344
- Meng C, Xing Y, Huo L, Ma H. Relationship between estimated glucose disposal rate and type 2 diabetic retinopathy. Diabetes Metab Syndr Obes. 2023;16:807–18. DOI: 10.2147/DMSO.S395818
- Behera R, Biswas J, Ray S, Sarkar I, Dey AK. Association of serum lipid profile and body mass index with diabetic retinopathy in type ii diabetes mellitus – a cross sectional study. Eur J Cardiovasc Med. 2023;13(4):419–24.
- Alvi R, Memon MS, Shera S, Mumtaz SN, Shaikh SA, Fahim MF. Visual outcome of laser treatment in diabetic macular edema: Study from an Urban Diabetes Care Center. Pak J Med Sci. 2016;32(5):1229–33. DOI: 10.12669/pjms.325.10597
- Hellmann F, Verdi M, Schlemper BR Jr, Caponi S. 50th anniversary of the Declaration of Helsinki: The double standard was introduced. Arch Med Res. 2014;45(7):600–1. DOI: 10.1016/j.arcmed.2014.10.005
- Luxmi S, Ritika M, Lubna A, Pragati G, Lal BB. Diabetic macular edema and its association to systemic risk factors in an urban north Indian population. J Clin Ophthalmol. 2018;2(2):86–91. DOI: 10.35841/clinical-ophthalmology.2.2.86-91
- Graue-Hernandez EO, Rivera-De-La-Parra D, Hernandez-Jimenez S, Aguilar-Salinas CA, Kershenobich-Stalnikowitz D, Jimenez-Corona A. Prevalence and associated risk factors of diabetic retinopathy and macular oedema in patients recently diagnosed with type 2 diabetes. BMJ Open Ophthalmol. 2020;5(1):e000304. DOI: 10.1136/bmjophth-2019-000304
- Raman R, Rani PK, Kulothungan V, Rachepalle SR, Kumaramanickavel G, Sharma T. Influence of serum lipids on clinically significant versus nonclinically significant macular edema: SN-DREAMS Report number 13. Ophthalmology. 2010;117(4):766–72. DOI: 10.1016/j.ophtha.2009.09.005
- Feng L, Nian S, Tong Z, Zhu Y, Li Y, Zhang C, et al. Age-related trends in lipid levels: A large-scale cross-sectional study of the general Chinese population. BMJ Open. 2020;10(3):e034226. DOI: 10.1136/bmjopen-2019-034226
- Kamoi K, Takeda K, Hashimoto K, Tanaka R, Okuyama S. Identifying risk factors for clinically significant diabetic macula edema in patients with type 2 diabetes mellitus. Curr Diabetes Rev. 2013;9(3):209–17. DOI: 10.2174/1573399811309030002
- Martín-Merino E, Fortuny J, Rivero-Ferrer E, Lind M, Garcia-Rodriguez LA. Risk factors for diabetic macular oedema in type 2 diabetes: A case-control study in a United Kingdom primary care setting. Prim Care Diabetes. 2017;11(3):288–96. DOI: 10.1016/j.pcd.2017.03.002
- Romero-Aroca P, Baget-Bernaldiz M, Fernandez-Ballart J, Plana-Gil N, Soler-Lluis N, Mendez-Marin I, et al. Ten-year incidence of diabetic retinopathy and macular edema. Risk factors in a sample of people with type 1 diabetes. Diabetes Res Clin Pract. 2011;94(1):126–32. DOI: 10.1016/j.diabres.2011.07.004
- Prakash GS, Kothari M. Risk factors associated with clinically significant macular edema in patients with type 2 diabetes mellitus. Int J Sci Stud. 2016;3(12):120–4.
- Vivsiana I, Marushchak M. Does the lipid profile depend on the comorbidity of overweight/obesity and arterial hypertension in patients with type 2 diabetes mellitus? Bull Med Biol Res. 2021;3(3):5–11. DOI: 10.11603/bmbr.2706-6290.2021.3.12560