Diabetic Eye Care: A Possible Prescription Link: Is it possible that the medicine you are currently taking for diabetes may have links to the development of eye disease? One new research report indicates it’s possible.
The American Journal of Ophthalmology suggests a class of diabetes drugs known as glitazones may increase the risk of vision complications in diabetics. The vision complication noted in the report is Diabetic Macular Edema (DME).
MedicineNet.com defines DME as the, “Swelling of the retina in diabetes mellitus due to leaking of fluid from blood vessels within the macula. The macula is the central portion of the retina, a small area rich in cones, the specialized nerve endings that detect color and upon which daytime vision depends.
“As macular edema develops, blurring occurs in the middle or just to the side of the central visual field. Visual loss from diabetic macular edema can progress over a period of months and make it impossible to focus clearly.
“Macular edema in common in diabetes. The lifetime risk for diabetics to develop macular edema is about 10%. The condition is closely associated with the degree of diabetic retinopathy (retinal disease). Hypertension (high blood pressure) and fluid retention also increase the hydrostatic pressure within capillaries which drives fluid from within the vessels into the retina.”
The research conducted relied on findings from nearly 1,000 patients who were diabetic, but also had DME. The findings showed that patients who relied on glitazones were, “2.6 times more likely to develop DME than those who didn’t take the drugs. Even after adjusting for other factors, the risk of DME remained 60 percent higher for patients who took glitazones”.
Dr. Thomas J. Liesegang, editor-in-chief of the American Journal of Ophthalmology was quoted as saying, “Ocular (eye) complications are an overlooked safety issue of systemic drugs. Long-term safety is not currently monitored, because the [FDA] approval process is based on smaller, shorter-term clinical trials. Safety necessarily requires monitoring of treatment in larger groups of people over longer periods of time. This monitoring is often neglected and should be required of all therapies.”
In January of this year German researchers expressed concern over the glitizones based drug, pioglitazone. The Institute for Quality and Efficiency in Health Care, a German based organization wrote, “There is so far a lack of scientific evidence that glitazones are better than alternative therapies at reducing mortality or complications caused by blood vessel damage in people with type 2 diabetes. As long-term studies are lacking, reliable conclusions on the long-term benefit or harm of these oral antidiabetics are presently possible only to a limited extent. Available studies provide indications that patients could benefit from one of the two currently approved active substances (pioglitazone); however, these studies also provide indications of potential disadvantages, including an increased risk of heart failure.”
One recent clinical trial suggests pioglitazone may cause weight gain and water retention in patients and was less effective in managing blood glucose levels.
While laser eye surgery is available to diabetic patients the recent body of research seems to imply that eye disease in diabetic patients should be strongly considered in the diabetic medications prescribed to patients.
The two primary glitazones generally prescribed to diabetic patients include pioglitazone (Actos) and rosiglitazone (Avandia). Evidence continues to suggest a link between these drugs and issues affecting the vision of diabetic patients who use them.