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Low Blood Sugar Worsen Eye Disease in People with Diabetes
People with diabetes who experience low blood sugar levels have a higher risk of worsening diabetic eye disease, says a study by researchers at Johns Hopkins Medicine. The study links low blood sugar with a molecular pathway activated in oxygen-starved eye cells.
Temporary low blood sugar, common in new diabetics, results in increased retinal cell proteins and blood vessel overgrowth, worsening diabetic eye disease, a preventable cause of blindness. The study suggests keeping stable glucose levels is important for diabetic retinopathy patients.
The researchers found low glucose levels in retinal cells cause a series of molecular changes that lead to blood vessel overgrowth. They plan to examine if the same occurs in other organs like the kidney and brain. The HIF-1α pathway may be a target for diabetic eye disease treatments.
“Temporary episodes of low glucose happen once or twice a day in people with insulin-dependent diabetes and often among people newly diagnosed with the condition,” says Akrit Sodhi, M.D., Ph.D., the Branna and Irving Sisenwein Professor of Ophthalmology at the Wilmer Eye Institute at Johns Hopkins Medicine. Low glucose levels can also occur during sleep in people with non-insulin dependent diabetes. “Our results show that these periodic low glucose levels cause an increase in certain retinal cell proteins, resulting in an overgrowth of blood vessels and worsening diabetic eye disease,” adds Sodhi.
Sodhi says the current study suggests that people with diabetic retinopathy may be particularly vulnerable to periods of low glucose, and keeping glucose levels stable should be an important part of glucose control.