Differences in lens opacification in type 2 diabetic patients on oral anti-diabetic medication or insulin therapy

Purpose Evaluation of the effects of different anti-diabetic therapies on light scattering in the lenses of type II diabetic patients compared to data from age-matched normal patients. Methods The anterior eye segment of 53 patients (20 males and 33 females, mean age 68,23 years) from a private practice, 25 of which were on insulin therapy and 28 on oral anti-diabetic therapies, were photographed with a Topcon SL-45 Scheimpflug camera on Kodak Tmax 400. After standard development the images were digitized and evaluated in respect to density in defined lens layers. Statistical comparison was performed with regression analysis between diabetics and normal patients for 9 defined lens layers. Results Density data in lens layers 1 – 3 and 5 – 8 did not differ between the 2 treatment groups, whereas in layer 4 (anterior lens cortex) light scattering was significantly lower than in the group of patients on oral anti-diabetic therapy. Gender had no influence on the data evaluated in this study. Conclusion In contrast to other, larger studies comparing different anti-diabetic therapies, this study shows a trend indicating that insulin might provide a better protection of lens crystallins against non-enzymatic glycosylation than oral anti-diabetic medication. Further studies are needed to differentiate between various oral anti-diabetic drugs.