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Visual functional defects in patients with type 2 diabetes mellitus: a questionnaire based cross-sectional study

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Abstract

Purpose

To determine the impact of type 2 diabetes mellitus (T2DM) on visual functions, identify different modifiers as risk or protective factors, and find out how these factors affect patients’ visual symptoms and visual functions as a whole.

Methods

We performed an online survey among 1030 participants (400 patients, 630 non-patients). Demographic features and severity of disease were documented, while visual functions were evaluated using National Eye Institute Visual Functioning questionnaire-25 (NEI VFQ-25). Independent t-test, analysis of variance, linear and nonlinear regression models were used to assess all data.

Results

Scores other than color vision among T2DM patients were significantly lower compared with non-T2DM participants. There was significant difference after stratification of age and education, but no significant difference between different genders was observed. Parameters including duration of T2DM, fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) negatively impacted on the scores, with 20 years’ of diabetic duration, 10 mmol/L of FPG, 7.5% of HbA1c being potential cut-off points. Poorer best corrected visual acuity (BCVA) and diagnosis of diabetic retinopathy were risk factors, while they simultaneously produced mediation effect, contributing 5%-78% of effect in the deterioration of visual functions caused by longer diabetic duration and higher blood glucose.

Conclusion

Significant visual impairments and faster deterioration in visual functions were seen in T2DM patients, with older age, lower educational level, longer diabetic duration, poorer blood glucose administration, limited BCVA, and the presence of diabetic retinopathy identified as risk factors. Average BCVA and diabetic retinopathy also yielded mediation effect as diabetic duration lengthened and blood glucose elevated.

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Funding

This study was supported by Beijing Key Laboratory Opening Funding (Grant number: BKLOF-BYSY202101).

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Author notes

  1. Sanbao Chai and Yimeng Ge are contributed equally to this work

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Peking University International Hospital, Beijing, 102206, People’s Republic of China

    Sanbao Chai

  2. Department of Opthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Peking University Third Hospital Haidian District, 49 North Garden Road, Beijing, 100191, People’s Republic of China

    Yimeng Ge, Yu Wan, Huaqin Xia, Ruilan Dong, Xiaotong Ren, Hao Yuan, Qingyi Hou, Jiarui Yang & Xuemin Li

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  1. Sanbao Chai
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Contributions

Study design and concept: SC, JY, XL; Data collection and analysis: YG, YW; Interpretation of data and critical revision of the manuscript: SC, YG, HX, RD, XR, HY, QH, JY; All authors have read and approved the final draft of the manuscript submitted.

Corresponding authors

Correspondence to Jiarui Yang or Xuemin Li.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee (Peking University Third Hospital Medical Science Research Ethics Committee, S2020023) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Chai, S., Ge, Y., Wan, Y. et al. Visual functional defects in patients with type 2 diabetes mellitus: a questionnaire based cross-sectional study. Int Ophthalmol 42, 2205–2218 (2022). https://doi.org/10.1007/s10792-022-02220-w

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