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Insulin Resistance And Glaucoma

Elevated Intraocular Pressure Is Associated With Insulin Resistance And Metabolic Syndrome.

Elevated Intraocular Pressure Is Associated With Insulin Resistance And Metabolic Syndrome.

Abstract BACKGROUND AND AIM: Elevated intraocular pressure (IOP), a well-known risk factor for glaucoma, has recently been shown to be associated with some metabolic complications and obesity. We investigated the link between IOP and metabolic disturbances, focusing especially on metabolic syndrome and insulin resistance. METHODS: Eye examinations, including IOP measurement, were conducted on 943 subjects (533 men and 410 women). Body mass index (BMI), percent body fat, waist circumference, systolic and diastolic pressure, fasting insulin, glucose, lipids, and other metabolic parameters were measured. The homeostasis model assessment (HOMA) score and McAuley index were calculated to assess whole-body insulin resistance. RESULTS: Both of these insulin resistance indices showed positive associations with IOP (p < 0.05), even after statistical adjustment for other risk factors. IOP was higher in participants with metabolic syndrome, as compared to those who did not have metabolic syndrome. The mean IOP tended to increase linearly with the presence of increasing numbers of components for metabolic syndrome. CONCLUSIONS: These results suggest that insulin resistance might contribute to an explanation that would account for many previous findings concerning the association between IOP and obesity, hypertension, and diabetes. Copyright 2005 John Wiley & Sons, Ltd. Continue reading >>

Visible Signs Of Insulin Resistance: Opportunities Lost

Visible Signs Of Insulin Resistance: Opportunities Lost

The hope of a young physician’s call for “Small fevers are gratefully accepted” can be matched by the despair of the senior physician’s “If only diabetes were a little more symptomatic.” The senior physicians’ hopes can be fulfilled to a certain extent—if only. While hypertension, hyperglycemia, and glaucoma may be asymptomatic, hirsutism and acne are not. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age [1]. Of its manifestations, hyperandrogenism and infertility are the most prominent which bring young girls and women to medical attention. Being seen primarily by gynecologists and cosmetologists, the metabolic profile associated with PCOS lay silent. Symptomatic treatment for acne, hirsutism, or menstrual irregularity appeared to solve the problem. It is now increasingly recognized that PCOS is a metabolic disorder with cosmesis and infertility being part of a spectrum that includes accelerated atherosclerosis, insulin resistance, coronary artery disease, obesity, and type 2 diabetes mellitus [1, 2]. The Androgen Excess Society criteria for diagnosis of PCOS included (a) hyperandrogenism, hirsutism and/or hyperandrogenemia; (b) ovarian dysfunction, oligo-anovulation and/or polycystic ovaries; and (c) exclusion of other androgen-excess or androgen-related disorders [3]. The recent position statement on PCOS from the European Society of Endocrinology [4] recognized its broad spectrum and emphasized the contributing roles of obesity; body composition; the occurrence of sleep disorders (that are related to obesity, insulin resistance, and diabetes mellitus) [5, 6, 7], with a separate section to cardiometabolic risk factors; and the need for targeting these along with infertility and hirsutism. The primary Continue reading >>

Doctor, I Have A Question.? What Is The Relationship Between Diabetes And Glaucoma? Written By Louis R. Pasquale, Md, Farvo

Doctor, I Have A Question.? What Is The Relationship Between Diabetes And Glaucoma? Written By Louis R. Pasquale, Md, Farvo

Assoc. Professor of Ophthalmology, Harvard Medical School Director, Glaucoma Service, Massachusetts Eye & Ear The relationship between diabetes and glaucoma can be controversial and confusing. First we must understand that there are two types of diabetes. In type 1 diabetes (T1D), there is a complete loss of the pancreatic beta cells that make insulin. The profound inability to make insulin in T1D necessitates that nearly all patients with this condition be treated with insulin replacement therapy. In type 2 diabetes (T2D), the cells that make insulin are not destroyed. In fact, T2D patients can typically make more insulin than patients without diabetes. When blood sugar levels are high, the secreted insulin is ineffective at lowering blood glucose levels, producing a state of insulin resistance. The treatment of T2D is often directed at lifestyle measures that reduce insulin resistance like diet and exercise, although some of these patients also require medications to lower blood sugar. Second, we must understand that there are many different types of glaucoma so we must both specify the type of diabetes (T1D or T2D) and the type of glaucoma we are referring to when we examine the relation between diabetes and glaucoma. One thing is clear: uncontrolled T1D or T2D for a long enough period will lead to the development of diabetic retinopathy, consisting of leaking blood vessels and poor retinal blood supply that disrupts retinal function. Left unchecked the retina becomes starved for oxygen and develops new blood vessels and the stimulus for new blood vessel formation can travel to the anterior segment of the eye. This triggers new blood vessel formation in the ocular anterior segment and interferes with the normal internal drainage system of the eye leading to elevated Continue reading >>

Glaucoma And Insulin Resistance - From Fda Reports

Glaucoma And Insulin Resistance - From Fda Reports

How to use the study: print a copy of the study and bring it to your health teams to ensure drug risks and benefits are fully discussed and understood. Subscribe to the study: get notified of updates to the study. Expand the study to include reports from both FDA and eHealthMe Insulin resistance and Glaucoma from FDA and eHealthMe reports Glaucoma Glaucoma (increased fluid pressure in the eye with vision loss) can be treated by Xalatan, Lumigan, Timolol maleate, Latanoprost, Travatan z (latest reports from 32,176 Glaucoma patients) Insulin Resistance Insulin resistance has been reported by people with diabetes, type 2 diabetes, type 1 diabetes, depression, bipolar disorder (latest reports from 2,215 Insulin resistance patients). Browse all symptoms of Glaucoma a b c d e f g h i j k l m n o p q r s t u v w x y z Could your drugs cause Insulin resistance Insulin resistance Other conditions that could case Insulin resistance Insulin resistance What would happen? Forecast new side effects and undetected conditions when you have Glaucoma and Insulin resistance. Can you answer these questions? Is the grape seed extract ok to take if you have narrow angle? I have been on Xalatan and Asopt for over 10 yrs. I recently changed doctors and he stopped all drops 2 months ago. Within 5 days I developed severe headaches 3-4 days per wk. I have never suffered from headaches previously. My pressures are remaining in the low to mid 20s and he claims it has ... I am a 75 year old female, have glaucoma for 20 years , or let's say treated for that period of time. Have been on Latanoprost up to about 2 years ago. .then my Dr. referred me to a specialist as one eye had pressure of 26 and a small catatact. New Dr. put me on dorzolamide-timolol. brought ... Hi guys, been on Victoza for 17 days Continue reading >>

7 Habits That May Prevent Glaucoma

7 Habits That May Prevent Glaucoma

Often called the “silent thief” of vision, glaucoma is a group of diseases that damages the optic nerve gradually — and often without any warning signs. The best way to save your sight from glaucoma is to catch it early, through regular comprehensive dilated eye exams. However, research studies have also supported some lifestyle changes to prevent glaucoma (and a few other diseases, too). We sat down with Louis R. Pasquale, M.D., Director of the Glaucoma Service at Mass. Eye and Ear, who offered 7 tips for glaucoma prevention. 1) Eat lots of leafy green vegetables. An observational study that followed 100,000 patients for 26 years found that boosting intake of leafy greens is associated with a reduced risk of developing primary open-angle glaucoma. Glaucoma damages the optic nerve, which carries visual information to the brain. Increased pressure from fluid in the eye or impaired blood flow to the optic nerve are thought to be hallmark causes of glaucoma. Leafy greens are loaded with nitrate, which your body converts to nitric oxide. Nitric oxide helps maintain optimal blood flow and potentially keeps eye pressure low. Eating two salads a day with romaine and leafy greens can lead to a 60 percent reduction in developing paracentral glaucoma. Bottom line: Fill your plate with leafy green vegetables—not only can this help prevent glaucoma, but it is also linked to lower rates of inflammation, cancer, heart disease and macular degeneration. 2) Protect your eyes from the sun—and start young. When you’re out in the sun, your eyes have to process a large number of light rays. Inevitably, some harmful UV rays will come your way. These UV rays could contribute to the formation of exfoliation material in the anterior segment of your eye, clogging the drain and dialin Continue reading >>

Doctors Make A Case For Glaucoma As Type 4 Diabetes

Doctors Make A Case For Glaucoma As Type 4 Diabetes

Scientists at the All India Institute of Medical Sciences (AIIMS) in New Delhi have outlined the role of insulin resistance in the development of glaucoma, a condition they claim should be known as "type 4 diabetes". This follows Alzheimer's disease being tagged by some in the international research community as type 3 diabetes earlier in the decade. Researchers Dr Muneeb Faiq, a clinical researcher working on glaucoma, neurodegeneration and diabetes, and Dr Tanuj Dada, (pictured) a professor of ophthalmology at AIIMS, claim in a paper published in Current Molecular Medicine that diabetes can afflict the brain and exist independently of the other types of diabetes. This brain diabetes may or may not be accompanied with high blood sugar. Their hypothesis is that the brain is a separate compartment and much of its metabolism is independent of systemic metabolism. Based on this idea, the researchers claim that the brain can suffer from diabetes (independent of regular type 1 and type 2 forms). If the diabetes affects the cerebral part it becomes Alzheimer's disease (type 3 diabetes) and if it afflicts the visual pathway it becomes glaucoma (type 4 diabetes). The researchers argue that the whole concept is based on insulin signalling and what they have termed "Insulin Hypofunctionality". Proper insulin signalling is important for the survival of neurons, particularly retinal ganglion cells (cells that die in glaucoma). Loss of healthy insulin signalling causes "Insulin Hypofunctionality" which leads to the activation of many disease pathways that finally culminate in irreversible vision loss. This discovery is expected to open a new field of therapy for glaucoma and neurodegenerative diseases based on the damage caused by insulin resistance. We kicked some goals for our mem Continue reading >>

Diabetes And Your Eyesight

Diabetes And Your Eyesight

Diabetes is a complex disease resulting from the inability of the body to produce insulin, a hormone that takes sugar out of the blood and into cells where it can be used for energy. Without enough insulin, there is too much sugar in your blood. It’s like having a car full of gas but no key; you have the fuel you need, but can’t start using it. Diabetes affects more than 29 million Americans. The most common form of diabetes is adult-onset diabetes. Adult-onset diabetes typically strikes those who are over 40, overweight and have a sedentary lifestyle. Other risk factors include those with a family history of diabetes and those belonging to certain ethnic groups. Persons of African, Native American, Japanese, Latino or Polynesian descent are more at risk. Diabetic Eye Disease A common complication of diabetes is diabetic eye disease. Diabetic eye disease refers to a group of sight-threatening eye problems that people with diabetes may develop. Glaucoma is one of these diseases. Diabetic eye disease also includes diabetic retinopathy and cataracts. Diabetic retinopathy, a disease which damages the tiny blood vessels in the retina (the light-sensitive tissue that lines the back of the eye) is the most common diabetic eye disease. Diabetic retinopathy affects nearly 7.7 million Americans age 40 and older. A cataract is a clouding of the eye’s lens that results in blurring of normal vision. People with diabetes are nearly twice as likely to develop cataracts as other adults. Cataracts also tend to develop at an earlier age. Diabetes and Glaucoma The relationship between diabetes and open-angle glaucoma (the most common type of glaucoma), has intrigued researchers for years. People with diabetes are twice as likely to develop glaucoma as are non-diabetics, although som Continue reading >>

Women With Type 2 Diabetes At Greater Risk For Glaucoma

Women With Type 2 Diabetes At Greater Risk For Glaucoma

Women with type 2 diabetes have a nearly twofold increased risk of developing primary open-angle glaucoma, the most common form of the disease. Among more than 76,000 women enrolled in the Nurses’ Health Study, those with type 2 diabetes had a relative risk for glaucoma of 1.82 even after the data were controlled for various glaucoma risk factors, said Louis R. Pasquale, M.D., and colleagues of the Massachusetts Eye and Ear Infirmary, and other Harvard-affiliated institutions. "While obesity fuels the type 2 diabetes epidemic, it appears that factors unrelated to obesity contribute to the positive association between type 2 diabetes and glaucoma; we were surprised to find this. "Our study had a large enough sample to allow us to focus on type 2 diabetes only and to study its relation to newly diagnosed primary open-angle glaucoma cases," they added. "We were also able to correct for other factors that could contribute to glaucoma. Our work suggests, but in no way proves, that factors other than lifestyle behavior contributing to insulin resistance could lead to elevated intraocular pressure and glaucoma." Primary open-angle glaucoma is the most common form of the disease, accounting for about 60% to 70% of all glaucoma cases. It’s one of the leading causes of blindness, and affects more than two million people in the United States, according to the National Eye Institute. In several large eye studies, type 2 diabetes has been associated with increased intraocular pressure, the most obvious sign of primary open-angle glaucoma. But although diabetes has been conclusively linked to retinopathy, its alleged association with glaucoma is controversial, Dr. Pasquale and colleagues wrote. To see whether there is an association between type 2 diabetes and glaucoma, the inves Continue reading >>

Diabetes Type 4: A Paradigm Shift In The Understanding Of Glaucoma, The Brain Specific Diabetes And The Candidature Of Insulin As A Therapeutic Agent

Diabetes Type 4: A Paradigm Shift In The Understanding Of Glaucoma, The Brain Specific Diabetes And The Candidature Of Insulin As A Therapeutic Agent

Abstract: In the present analysis, we aim at probing into many important mechanisms that serve to bridge conceptual gaps to fill up the mosaic of a picture revealing that glaucoma indeed is brain specific diabetes and more appropriately “Diabetes Type 4”. Based on this conceptual substance, we weave a novel idea of insulin being a potential remedy for glaucoma. This analysis synthesizes upon the published literature on brain changes in glaucoma, possibility of isolated brain diabetes, insulin signaling glitches in glaucoma pathology, mitochondrial dysfunction and insulin resistance in glaucomatous eyes, insulin mediated regulation of intraocular pressure and its dysregulation in mitochondrial dysfunction. We also look into the role of amyloidopathy and taupathy in glaucoma pathogenesis vis-à-vis insulin signaling. At every step, the discussion reveals that insulin and other allied moieties are a sure promise for glaucoma treatment and management. In this article, we aim at synthesizing a persuasive and all inclusive picture of glaucoma etiopathomechanism centered on “insulin-hypofunctionality” in the central nervous system (i.e. brain specific diabetes). We start with considering the possibility of neurodegenerative diabetes that exists independent of the peripheral diabetes. Once that condition is met, then a metabolic conglomeration of this brain specific diabetes is deliberated upon leading us to understand the development of retinal ganglion cell apoptosis, intraocular pressure elevation, optic cupping and mitochondrial dysfunction. All these are the hallmarks and sufficient conditions to satisfy the diagnostic criteria for glaucoma. Immediate application of this analysis points towards glaucoma therapy centered upon improving what we have termed insulin-hy Continue reading >>

Good Hope, Heartlands, And Solihull Eye Clinics

Good Hope, Heartlands, And Solihull Eye Clinics

Links What is myopia ..spectacles Myopia occurs when light is focused in front of the retina. A minus lens will focus the light further back on the retina. enlarge myopia: light focuses in front of the retina a minus lens focuses light further back onto the retina Short-sighted Another term for myopia is short sighted...that is everything close is clear, everything far away is out of focus and blurred. If an eye is -3.00 diopters myopic, as opposite, distance vision is blurred, reading is clear and focused. Enlarge. 3 optical causes of myopia Theoretically myopia can occur for 3 reasons... the eye is longer than usual...this is termed axial myopia. This is the commonest form of myopia. This is common, discussed below. Less common: the cornea is more curved than usual and so is stronger. The light is focused too far forward, in front of the retina A low degree of myopic can be caused as we get older by lens changes: the lens of the eye becomes stronger, as in early cataract formation. The stronger lens focuses the light too far forward. Glasses or contact lenses etc Spectacles or contact lenses help most people see really well. But if you have significant myopia, and cannot wear contact lenses, laser refractive surgery may help. This another strongly recommends glasses and contact lenses. Children. The causes of (axial length) myopia...abnormal eye growth Axial length myopia...that is a large eye, may develop in utero or at a very young age ...the eye may grow quickly or 'ballistically'. due to lack of control of visually guided growth genetic causes (including some of those causing high myopia above) reading & close work when young does lengthen the eye and causes myopia BJO 2011 education levels in Singapore Eye 12 cataracts or anything preventing light reaching retina Continue reading >>

Insulin Resistance And Autoregulatory Dysfunction In Glaucoma And Retinal Vein Occlusion

Insulin Resistance And Autoregulatory Dysfunction In Glaucoma And Retinal Vein Occlusion

Ophthalmologists rarely are perturbed to discover that their patients also have some or all of the following: hypertension, diabetes, hyperlipidemia, and coronary artery disease. The pivotal role of insulin resistance in producing this constellation of disorders was recognized almost 20 years ago by Reaven.1 To access this article, please choose from the options below View All Continue reading >>

Glaucoma Steals Sight Without Warning

Glaucoma Steals Sight Without Warning

Early diagnosis and treatment are essential to slow the progression of glaucoma and preserve vision. George S. knew that to maintain healthy teeth, he needed to brush them twice a day and visit his dentist regularly, which he did. But George didn’t realize that regular eye exams are just as important to preserving one’s eye health—until he developed glaucoma. Up until then, the only time George had visited his eye doctor was when his vision had changed and he needed a new contact lens prescription. He was unaware of the disease that was slowly stealing his sight because his vision was fine. There are no symptoms in glaucoma’s earliest stages. By the time George developed symptoms and visited his eye doctor, he had lost 70 percent of his eyesight permanently. That’s why glaucoma is called the “silent thief of sight.” And that’s why regular eye exams—like regular dental check-ups—are critical to maintain health. Early diagnosis and treatment are essential to slow the progression of glaucoma and preserve vision. Prevent Blindness America has designated January as Glaucoma Awareness Month to emphasize the importance of getting regular comprehensive eye exams to check for glaucoma. This sight-stealing disease currently affects more than 4 million Americans. Only half have been diagnosed. Delayed diagnosis and treatment have made glaucoma the second leading cause of blindness in the U.S. What is Glaucoma? Glaucoma is a group of eye disorders that cause gradual damage to the optic nerve, a bundle of more than 1 million nerve fibers that send images from the eye to the brain. A healthy optic nerve is necessary for good vision. The most common form of the disease, primary open-angle glaucoma, is associated with increased eye pressure, which can slowly damage Continue reading >>

Glaucoma And Diabetes: Can Diabetes Affect Your Eyes?

Glaucoma And Diabetes: Can Diabetes Affect Your Eyes?

People with diabetes are twice as likely to be at risk of having glaucoma compared to people without diabetes. We will first look at how the eye works, what glaucoma is, followed by the relationship between glaucoma and diabetes. Clara’s story Clara’s eyes were feeling tired all of the time. She was attributing the tiredness to her Type 2 diabetes, but she wasn’t too sure about it. That’s why she contacted TheDiabetesCouncil to raise her concerns about the increasing pressure in her eyes. Her left eye had suddenly become red, and she was experiencing sharp pain in her eyes. She had somewhat of a headache, too. After hearing about Clara’s symptoms, she was advised to see her eye doctor for an examination, as glaucoma was suspected. Clara got in touch with us to report that she had been to her ophthalmologist, and she had been diagnosed with the most common type of glaucoma, open-angle glaucoma. She was using some drops in both eyes, and she relayed that she was feeling better, and that the pain in her eye and other symptoms have subsided. To help others in Clara’s situation, we have written this comprehensive guide about glaucoma and diabetes. How does the eye work? If you want to understand eye diseases, specifically glaucoma, it’s important to understand how the eye operates. It’s an incredible, wonderful organ! Without our eyes, we could not see the world around us. The eye is a spherically shaped organ that has a tough outer surface. The covering in the front of the eye is curvy. This covering is called the cornea. The cornea is responsible for focusing light. It also serves to protect the eye. Light makes its way through the eye by way of the anterior chamber. In this chamber, there is fluid called aqueous humor that the light travels through. Light Continue reading >>

Is Glaucoma A Neurodegeneration Caused By Central Insulin Resistance: Diabetes Type 4?

Is Glaucoma A Neurodegeneration Caused By Central Insulin Resistance: Diabetes Type 4?

JOCGP Is Glaucoma a Neurodegeneration caused by Central Insulin Resistance: Diabetes Type 4? Tanuj Dada How to cite this ar t icle: Dada T. Is Glaucoma a Neurodegeneration caused by Central Insulin Resistance: Diabetes Type 4? J Curr Glaucoma Pract 2017;11(3):77-79. Source of support: Nil Conflict of interest: None INTRODUCTION Glaucoma is an acquired multifactorial progressive neu- rodegenerative syndrome with complex pathogenesis. It is characterized by accelerated retinal ganglion cell (RGC) apoptosis and leads to optic neuropathy with visual field defects, the intraocular pressure (IOP) being a major risk factor. The only therapy currently available is lowering of IOP with medical/laser/surgical therapy; however, many patients continue to progress despite an adequately con- trolled or apparently “normal†IOP. Recent studies have shown that glaucoma patients have central neurodegenera- tion involving both the occipital cortex and lateral genicu- late body (LGB).1,2 It has been postulated that glaucoma may be a disease initially affecting the central nervous system (CNS) and traveling downstream to the optic nerve and RGCs. Our group recently proposed a novel theory for glaucoma—the brain diabetes theory (describ- ing glaucoma as diabetes type 4).3,4 This theory explains that glaucoma is a CNS condition involving brain insulin resistance or central insulin signaling dysfunction, which leads to transsynaptic neurodegeneration. This proposal has given rise to a new holistic theory for primary open angle glaucoma (POAG)/normal pressure glaucoma and raised the possibility of the development of therapeutic approaches targeting the brain rather than the eye. Diabetes types I and II are insulin hypofunctionality- mediated systemic syndromes accompanied by hy Continue reading >>

Methazolamide Is A New Hepatic Insulin Sensitizer That Lowers Blood Glucose In Vivo

Methazolamide Is A New Hepatic Insulin Sensitizer That Lowers Blood Glucose In Vivo

We previously used Gene Expression Signature technology to identify methazolamide (MTZ) and related compounds with insulin sensitizing activity in vitro. The effects of these compounds were investigated in diabetic db/db mice, insulin-resistant diet-induced obese (DIO) mice, and rats with streptozotocin (STZ)-induced diabetes. MTZ reduced fasting blood glucose and HbA1c levels in db/db mice, improved glucose tolerance in DIO mice, and enhanced the glucose-lowering effects of exogenous insulin administration in rats with STZ-induced diabetes. Hyperinsulinemic-euglycemic clamps in DIO mice revealed that MTZ increased glucose infusion rate and suppressed endogenous glucose production. Whole-body or cellular oxygen consumption rate was not altered, suggesting MTZ may inhibit glucose production by different mechanism(s) to metformin. In support of this, MTZ enhanced the glucose-lowering effects of metformin in db/db mice. MTZ is known to be a carbonic anhydrase inhibitor (CAI); however, CAIs acetazolamide, ethoxyzolamide, dichlorphenamide, chlorthalidone, and furosemide were not effective in vivo. Our results demonstrate that MTZ acts as an insulin sensitizer that suppresses hepatic glucose production in vivo. The antidiabetic effect of MTZ does not appear to be a function of its known activity as a CAI. The additive glucose-lowering effect of MTZ together with metformin highlights the potential utility for the management of type 2 diabetes. Despite significant advances in knowledge, the prevalence of type 2 diabetes and comorbidities continues to increase (1) and alternative ways of tackling this disease are needed. The molecular complexity of insulin resistance is reflected by the requirement in most cases for combination therapy to improve metabolic control; yet even this Continue reading >>

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