Abstract
The purpose of this study was to analyze the risk of glaucoma based on diabetes status using a large nationwide longitudinal cohort of postmenopausal women. This study included 1,372,240 postmenopausal women aged ≥ 40 years who underwent National Health Screening Program in 2009. Subjects were classified into the following 5 categories based on diabetes status: no diabetes, impaired fasting glucose (IFG), new onset diabetes, diabetes treated with oral hypoglycemic medication, and diabetes treated with insulin. Subjects were followed from 2005 through 2018, and hazard ratios of glaucoma onset were calculated for each group. Subgroup analyses of subjects stratified by age, smoking, drinking, hypertension, and dyslipidemia were performed. During the follow up period, 42,058 subjects developed glaucoma. The adjusted hazard ratio was 1.061 (95% CI, 1.036–1.086) in the IFG group, 1.151 (95% CI, 1.086–1.220) in the new onset diabetes group, 1.449 (95% CI, 1.406–1.493) in the diabetes treated with oral hypoglycemic medication group, and 1.884(95% CI, 1.777–1.999) in the diabetes treated with insulin group compared to the no diabetes group. The results were consistent in subgroup analyses after stratifying by age, lifestyle factors (smoking and drinking), and comorbidities (hypertension and dyslipidemia). Diabetes status is associated with increased risk of glaucoma development in postmenopausal women.
Highlights
The purpose of this study was to analyze the risk of glaucoma based on diabetes status using a large nationwide longitudinal cohort of postmenopausal women
We used a large nationwide cohort of postmenopausal women to determine the risk of glaucoma onset in subjects with no diabetes, impaired fasting glucose (IFG), new onset diabetes, diabetes treated with oral hypoglycemic medication, or diabetes treated with insulin
Diabetes status was stratified into 5 categories using the data within one year prior to the index date: (1) normal, (2) IFG, (3) new onset diabetes, (4) diabetes treated with oral hypoglycemic medication, and (5) diabetes treated with insulin
Summary
The purpose of this study was to analyze the risk of glaucoma based on diabetes status using a large nationwide longitudinal cohort of postmenopausal women. Diabetes status is associated with increased risk of glaucoma development in postmenopausal women. The association between diabetes and IOP was weak in previous studies, and the most prevalent type of glaucoma in Korea is normal tension g laucoma[7,8,9] In this regard, diabetes has been suggested to cause microvascular damage and vascular dysregulation of the optic nerve head which increases the susceptibility to glaucomatous d amage[4,5,6]. We used a large nationwide cohort of postmenopausal women to determine the risk of glaucoma onset in subjects with no diabetes, IFG, new onset diabetes, diabetes treated with oral hypoglycemic medication, or diabetes treated with insulin
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