INSULIN RESISTANCE AND DIABETIC MACULAR EDEMA IN TYPE 2 DIABETES MELLITUS
Résumé
Objective: Evaluate the association between insulin resistance and diabetic macular edema in type 2 diabetes Methods: Cross-sectional study. Type 2 diabetes patients who agreed to undergo blood sample extraction were enrolled. Patients who had received treatment for macular edema within the past 3 months and those with other retinal diseases were excluded. The following data were recorded: age, sex, time of diabetes evolution, HbA1C, ophthalmologic and systemic treatment, and lens status. Optic coherence tomography was performed to determine the morphologic patterns of macular edema. Insulin resistance was established on a McAuley index of <6.3 and fasting insulin levels of >16 mU/L. Results: 177 eyes from 90 patients were included; 27.1% of eyes were from insulin-resistant patients. There were no differences in age, time of evolution, sex, HbA1C or lens status between insulin resistant and nonresistant patients Insulin resistant patients were more likely to have exogenous insulin therapy (P<0.05; OR=3.8). An association was found between diabetic cystoid macular edema and resistance (Fisher exact test P=0.007; OR=2.53, 95% CI: 1.52-4.2). There were no associations between insulin resistance and the other morphologic patterns of edema. Patients undergoing insulin therapy were found to have an association with a diffuse retinal thickening pattern on OCT (P=0.036; OR=1.4). However, no association was found between insulin therapy and the presence of cystoid macular edema. Conclusions: The findings of this study indicate a relationship between insulin resistance and cystoid macular edema, which is not related to the use of insulin. Insulin treatment was associated with diffuse macular edema.
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