The risks of uncontrolled diabetes on the eye due to microvascular damage caused by elevated blood glucose are well known. However, a new study highlights additional dangers that warrant further consideration and, perhaps, enhanced screening in diabetic patients. All individuals are at increased risk of cataract formation with advancing age; however, it appears that adults with diabetes over the age of 40 are at even greater peril.  

A new study published in Great Britain aims to identify additional risks to ocular health beyond those already recognized in patients with diabetes. Becker et al analyzed the risk of incident cataracts in patients both with and without diabetes. The patients evaluated were all aged 40 years or older and were newly diagnosed with diabetes. Researchers also evaluated other comorbid conditions, duration of diabetes diagnosis, and medications that the patients had used for the treatment of diabetes. The authors of the report, published this month, demonstrated that diabetes doubles an individual’s risk of also being diagnosed with cataracts. The risk is six times higher, the study authors note, if a diabetic patient has significant diabetic maculopathy.

Study coauthor Rupert Bourne, Professor of Ophthalmology at Anglia Ruskin University in England, highlighted the findings showing that the general population experiences an overall rate of 10.8 cataracts diagnosed per 1,000 individuals, compared to diabetic patients aged 40 years or older at a rate of 20.4 cataracts diagnosed per 1,000 individuals. There were 56,510 diabetic patients included in the study, and the confidence intervals of cataract formation of those with and without diabetes were 95% CI 19.8–20.9 and 95% CI 10.5–11.2, respectively. “This is only the second such report on cataract incidence in the UK’s diabetic patients since the 1980s and it further emphasizes the importance of the screening programs in early identification and treatment of diabetic eye disease to prevent sight loss,” said Bourne.

While patients aged 45 to 49 years were at 4.6 times higher risk, patients aged 50 to 54 years were at even higher risk, with 5.7 times more risk than those without diabetes. Because this study used data from a datalink covering roughly 7% of the United Kingdom population, it was accepted as a balanced representation of the overall demographic characteristics of that geographic distribution. “This is an interesting example of how a very large primary care dataset of electronic patient data, in this case the Clinical Practice Research Datalink, can be used to investigate risk factors for eye disease,” Bourne said.