A new study supported by the National Institutes of Health has found that low blood sugar, also known as hypoglycemia, may play a role in damaging the eye’s retina in people with diabetes.
Researchers from the Wilmer Eye Institute at Johns Hopkins Medicine discovered that hypoglycemia can break down the blood-retinal barrier, a protective layer that controls what enters and exits the retina.
This damage may help explain the development and worsening of diabetic retinopathy, a serious eye disease that can lead to permanent vision loss.
Diabetic retinopathy is a common complication of both type 1 and type 2 diabetes. It occurs when blood vessels in the retina—the light-sensitive tissue at the back of the eye—start to leak or grow abnormally.
Until now, much of the focus has been on the effects of high blood sugar. This new research shows that low blood sugar can also be harmful, especially in people who experience large swings in their glucose levels.
The study, published in the journal Science Translational Medicine, identified a key protein called hypoxia-inducible factor (HIF) that builds up in the retina during low blood sugar. HIF is known to trigger the production of other proteins that make blood vessels grow and leak.
Researchers found that in diabetic mice, HIF levels increased significantly during hypoglycemia, enough to cause the blood-retinal barrier to break down. This did not happen in mice without diabetes.
To test whether HIF was responsible, the scientists used an experimental drug called 32-134D to block HIF. Diabetic mice were given the drug before being exposed to low blood sugar. The results were promising: HIF levels were lower, fewer damaging proteins were made, and the blood vessels in the retina did not leak.
These findings could help explain why some people with diabetes who begin tight glucose control—carefully managing their blood sugar—sometimes see a temporary worsening of their eye disease. Fluctuations between low and high blood sugar can lead to spikes in HIF, which then damages the eye.
According to Dr. Akrit Sodhi, the lead researcher, this study shows that targeting HIF may be an effective way to prevent or treat diabetic retinopathy.
The research team is planning more studies to understand how HIF affects the blood-retinal barrier and to test the safety and effectiveness of 32-134D in humans. If successful, the drug could become a new treatment for diabetic eye disease, giving hope to millions of people living with diabetes.
If you care about diabetes, please read studies about bananas and diabetes, and honey could help control blood sugar.
For more health information, please see recent studies about Vitamin D that may reduce dangerous complications in diabetes and results showing plant-based protein foods may help reverse type 2 diabetes.
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