Meibomian Gland Dysfunction in Type 2 Diabetic Patients.

Xiaolei Lin,Yana Fu,Yun-E Zhao,Junhua Li,Xuewen Chen,Binbin Xu,Yinying Zhao,Yuxi Zheng,Terry G Coursey

doi:10.1155/2017/3047867

Abstract

Purpose To investigate meibomian gland and tear film function in patients with type 2 diabetes. Methods This prospective study compared changes in meibomian gland and tear film function in type 2 diabetic patients with nondiabetic patients. Meibomian gland function was evaluated by measuring lipid layer thickness (LLT), grading of meibomian gland loss, lid margin abnormalities, and expression of meibum. Tear film function was assessed by measuring tear breakup time (TBUT), the Schirmer I test, noninvasive breakup time (NIBUT), tear meniscus height (TMH), and corneal fluorescein staining. Results Meibography scores were significantly higher in the diabetic group compared with the nondiabetic group (p = 0.004). The number of expressible glands was significantly lower in the diabetic group in temporal, central, and nasal third of the lower eyelid (nasal: p = 0.002; central: p = 0.040; and temporal: p = 0.039). The lid margin abnormality score was significantly higher in the diabetic group than in the nondiabetic group (p = 0.04). There was no statistically significant difference in the tear film function parameters between the two groups. Conclusions Meibomian gland dysfunction (MGD) in type 2 diabetic patients is more severe compared with nondiabetic patients. Overall, most of the diabetic patients manifest as having asymptomatic MGD.

Highlights

Diabetes is a very common chronic disease and is a main cause of mortality and socioeconomic burden worldwide
The mean fasting plasma glucose was 7.75 ± 1.43 mg/dl. 52.8% of the participants used oral glucose-lowering drugs (OGLDs), while 33.3% took insulin, and 13.9% were on OGLDs plus insulin
Our study revealed that meibomian gland morphology and dysfunction, including meibography scores, lid margin abnormalities, and meibum expressibility, were found to be significantly worse in patients with type 2 diabetes

Summary

Introduction

Diabetes is a very common chronic disease and is a main cause of mortality and socioeconomic burden worldwide. Ocular disorders are common in diabetic patients, such as retinopathy, corneal epithelial erosions, and dry eye [3, 4]. Despite the abundance of information available concerning the various complications of chronic diabetes, the effects of this disease on ocular disorders, dry eye, are not yet fully appreciated. Tear function in diabetic patients, especially patients suffering proliferative diabetic retinopathy, was commonly worse than nondiabetic people [6]. The outcome of another large epidemiologic study in Spain suggested that diabetes was associated with asymptomatic meibomian gland dysfunction (MGD), a major cause of ocular discomfort and inflammation [7]

Methods

Results

Conclusion