A new study funded by the National Institutes of Health has found that low blood sugar, or hypoglycemia, might play a harmful role in diabetic eye disease.
The research was led by scientists at the Wilmer Eye Institute at Johns Hopkins Medicine. They discovered that low blood sugar may damage the blood-retinal barrier, a key part of the eye that controls what goes in and out of the retina.
This discovery gives new insight into diabetic retinopathy, a serious complication of diabetes that can lead to vision loss if not treated. Both type 1 and type 2 diabetes can cause this condition. The study focused on mice with diabetes and looked at how their eyes responded to low blood sugar levels.
The research, published on April 30 in the journal Science Translational Medicine, found that during hypoglycemia, a protein called hypoxia-inducible factor, or HIF, builds up in certain cells in the retina.
HIF has been linked to diabetic eye problems before. It can cause the body to make too many other proteins that lead to the growth and leaking of blood vessels in the eye, which harms vision.
In their experiments, the scientists created low blood sugar conditions in mice, some of which had diabetes. They found that in diabetic mice, low blood sugar triggered high levels of HIF, which led to damage in the blood-retinal barrier and leaking blood vessels in the eye. In contrast, mice without diabetes did not show this response.
To learn more, the researchers tested a new drug called 32-134D that blocks HIF. When diabetic mice received this drug before going through hypoglycemia, their HIF levels stayed lower, and there was less damage to the blood-retinal barrier. The drug seemed to prevent the chain reaction that leads to blood vessel leakage and vision problems.
Dr. Akrit Sodhi, the lead author of the study and a professor at Johns Hopkins, explained why this research matters.
He said it helps explain why some people with diabetes experience worsening eye disease when they start tight blood sugar control or have large swings in their blood sugar levels. These ups and downs in blood sugar may activate harmful processes in the eye.
Dr. Sodhi said the results show that new treatments that block HIF could help protect the eyes of people with diabetes. The research team hopes to do more studies on HIF, the blood-retinal barrier, and the 32-134D drug. Eventually, they want to test the drug in people with diabetic eye disease.
This study offers hope for better ways to treat or even prevent vision loss in people with diabetes.
If you care about eye health, please read studies about how vitamin B may help fight vision loss, and MIND diet may reduce risk of vision loss disease.
For more information about eye disease, please see recent studies about how to protect your eyes from glaucoma, and results showing this eye surgery may reduce dementia risk.
The study findings can be found in Science Translational Medicine.
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