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Diabetes Medication May Prevent Glaucoma

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS
Last Updated: December 6, 2021

Diabetes and glaucoma are two very serious diseases. Both usually affect adults. The two diseases have a connection, and now some medications that treat diabetes might help prevent glaucoma.

 

What is Glaucoma?

Glaucoma is a group of diseases that causes damage to the eye. Glaucoma damages the optic nerve, causing vision loss and can lead to blindness, and is the leading cause of blindness in the United States.

 

Types of Glaucoma

There are primary types of glaucoma and secondary types of glaucoma. Primary types of glaucoma do not have another condition that causes glaucoma. Secondary glaucoma is the result of another medical condition.

 

Primary Glaucomas

Open-angle glaucoma is the most common type of glaucoma in the United States. Nine out of ten people with glaucoma have this form.

The cause is not clear, but experts think it is pressure built up in the eye due to a problem with fluid not draining fast enough from the eye. That pressure damages the optic nerve over time and leads to vision loss.

Normal-tension glaucoma is a type of open-angle glaucoma that happens in people with normal eye pressure.

Angle-closure glaucoma is also called acute glaucoma and is a medical emergency. If it is not treated right away, it can cause blindness in a few days. Get medical treatment right away if the following symptoms suddenly occur:

  • Red eyes
  • Intense eye pain
  • Blurry vision
  • Nausea and vomiting

Congenital glaucoma is when babies are born with an eye problem that stops fluid from draining normally. Signs are noticeable right away:

  • May have eyes that are larger than normal
  • Sensitivity to light
  • Making extra tears
  • Having cloudy eyes

This is very rare; 1 in 10,000 babies in the United States are born with this. If babies have eye surgery soon enough, there usually will be no vision loss.

 

Secondary Glaucomas

Neovascular glaucoma happens when extra blood vessels form over the part of the eye where fluid normally drains. This is usually caused by diabetes or high blood pressure.

Pigmentary glaucoma happens when pigment (color) from the iris flakes off and stops fluid from draining out of the eye. This can be treated by lowering eye pressure, but there is not yet a way to stop the pigment from flaking off.

Exfoliation glaucoma happens in people with exfoliation syndrome. This causes extra material to deposit in the eye, blocking fluid from draining. This type can progress fast, it is important for people with this condition to get regular eye exams.

Uveitic glaucoma can happen to people with uveitis. This is a condition that causes swelling and inflammation in the eye.

 

Symptoms of Glaucoma

In the beginning, there are not usually any symptoms. Half of the people who have glaucoma do not realize they have it.

Eventually, people start to notice they are losing their peripheral (side) vision. Without treatment, glaucoma causes blindness.

 

Glaucoma Treatments

It is important to start glaucoma treatment right away. People can not get back the vision they have already lost, but treatment will stop additional vision loss.

Treatments for glaucoma include laser treatment, surgery, and medications. Medications for glaucoma are usually eye drops, including:

 

The Diabetes Glaucoma Connection

Having diabetes can increase the risk of developing glaucoma by 36%. Diabetic retinopathy, a complication of long-term diabetes, is what increases the glaucoma risk. There are primary ways in which high blood sugar can damage the eye.

One way is that high glucose levels cause swelling in the eye tissues. Over time, the high glucose levels damage the blood vessels in the eye. New blood vessels will start to grow and can cause high pressure in the eye.

A second possibility is that high blood sugar can cause an increase in a protein called fibronectin to form in the eye. The increase of fibronectin can block the eye’s natural drainage system, leading to glaucoma.

 

Diabetes Medications

Diabetes is a chronic health condition. When someone eats, the food is broken down into sugar to be used for energy. When blood sugar goes up after eating, the pancreas releases insulin. 

Insulin moves the sugar into the cells of the body so it can be turned into energy. Someone who has diabetes does not have enough insulin, or their body does not use the insulin that is made. The sugar stays in the bloodstream.

High blood sugar over time can lead to heart disease, kidney disease, and vision loss. There is no cure for diabetes, but medications and eating well and exercise can make a difference.

There are several different types of medications to help treat type 2 diabetes. One of these types has recently been linked to glaucoma prevention: GLP-1 agonists. The study suggests that the risk of developing glaucoma can be cut in half by GLP-1R agonists.

GLP-1 agonists copy the action of GLP-1, a hormone that causes the pancreas to produce more insulin. Insulin keeps blood glucose levels in the normal range. The effects of the hormone GLP-1 lasts only minutes. Conversely, the GLP-1 receptor agonists medication can last for hours or days.

GLP-1 agonists available include:

Every person has a different response to medications. What works for one person may not keep blood sugar levels in the normal range for the next person. There are other types of diabetes medications.

Biguanides decrease the amount of sugar the liver makes. They also make the body more sensitive to insulin, helping the muscles absorb glucose. Some examples are Metformin, Jentadueto, and Janumet

Dipeptidyl peptidase-4 (DPP-4) inhibitors help the body make insulin. This type of medication helps reduce blood sugar without causing hypoglycemia (low blood sugar). Examples of DPP-4 inhibitors include:

Sodium-glucose transporter (SGLT2) inhibitors work by stopping the kidneys from holding onto glucose. Glucose leaves the body through urine instead. Examples of SGLT 2 inhibitors include:

 

Get Help Paying for Glaucoma Medications

The Rx Advocates helps people get diabetes and glaucoma medications they need at a reasonable monthly rate. This includes some GLP-1 agonist medications that treat diabetes and lower the risk of developing glaucoma. Contact us today for more information.

 

Sources:

MedlinePlus. Glaucoma. https://medlineplus.gov/glaucoma.html.

National Eye Institute. Types of Glaucoma. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/types-glaucoma.

Rhopressa. Consistent IOP reduction for more patients. https://rhopressa.com/.

Medscape. Apraclonidine. https://reference.medscape.com/drug/iopidine-apraclonidine-343591.

Emc. Betoptic 0.25% Eye Drops Suspension. https://www.medicines.org.uk/emc/product/835/smpc#gref.

Healthline. Diabetic Retinopathy. https://www.healthline.com/health/type-2-diabetes/retinopathy.

NIH National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic Eye Disease. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-disease.

PMC. Diabetes and Risk of Glaucoma: Systematic Review and a Meta-analysis of Prospective Cohort Studies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596230/

CDC. Diabetes. https://www.cdc.gov/diabetes/basics/diabetes.html.

Penn Medicine News. Diabetes Medications Linked to Glaucoma Prevention. https://www.pennmedicine.org/news/news-releases/2021/september/diabetes-medications-linked-to-glaucoma-prevention.

Hormone Health Network. GLP1 Receptor Agonists. https://www.hormone.org/diseases-and-conditions/diabetes/medicines-and-treatment/glp1-receptor-agonists

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