Can Insulin Resistance Serve as a Potential Biomarker for the Development of Clinically Significant Macular Oedema in Patients with Type 2 Diabetes Mellitus?

Objective: To study the prevalence of insulin resistance among diabetic patients. To analyze the association between insulin resistance and clinically significant macular edema (CSME) development. Material and Methods: Single-centre, cross-sectional comparative study on a hospital-based population of diabetic patients. Patients were grouped based on the presence of CSME (group A) and the absence of CSME (group B). Simple logistic regression and multiple logistic regression analyses were performed to evaluate the association CSME with age, duration of diabetes, HbA1c, insulin resistance, body mass index, and lipid profile. Results: The study cohort comprised 86 patients with type 2 DM, with a mean age of 60+7 years. We included 43 patients in each group A and B respectively. There were 37 patients (86%) in group A, who had diabetes >10 years. In group B, 23 patients (53%) had diabetes >10 years. The mean HbA1c was found to be 8.2+1.3 mmol/ mol in group A and 7.6+0.85 mmol/mol in group B (p=0.01). Increased insulin resistance was present in 74/86 (86 %) of diabetics. Elevated IR of > 3.8 was found in 32/43 patients (74%) of group A and 17/43 (39%) of group B (p= 0.001). None of the patients in group A had normal insulin resistance. The odds ratio for the development of CSME in patients with increased HOMA-IR was found to be >4. Conclusion:We observed positive association between insulin resistance and development of clinically significant macular edema. The odds for the development of macular edema was greater in uncontrolled diabetics with elevated insulin resistance.