A new study funded by the U.S. National Institutes of Health has found that low blood sugar, also known as hypoglycemia, may harm the eyes of people with diabetes.
Researchers at the Wilmer Eye Institute at Johns Hopkins Medicine discovered that low blood sugar can break down a protective barrier in the eye called the blood-retinal barrier.
This barrier controls how nutrients, water, and waste move in and out of the retina, which is the part of the eye that helps us see.
This new research gives doctors a better idea of how diabetic retinopathy begins, especially in people who have episodes of low blood sugar. Diabetic retinopathy is a serious eye disease that can happen to people with type 1 or type 2 diabetes. If not treated, it can lead to permanent vision loss.
The full study was published in the journal Science Translational Medicine. It explains that when blood sugar drops, a protein in the retina called HIF (short for hypoxia-inducible factor) builds up.
This protein has already been linked to diabetic eye problems and other diseases of the eye. HIF can start a harmful chain reaction by triggering the body to make too many other proteins. These proteins cause blood vessels in the retina to grow too much and leak, which damages the eye.
In this study, scientists tested this theory using diabetic and non-diabetic mice. They lowered the mice’s blood sugar and watched what happened. The diabetic mice had much higher levels of HIF during low blood sugar episodes.
These higher levels caused the blood-retinal barrier to break down, which led to leaking blood vessels in the retina. This kind of leak and damage is part of what causes vision loss in diabetic retinopathy. Interestingly, the non-diabetic mice did not show the same increase in HIF or the same damage.
The scientists also tested a new drug called 32-134D. This drug blocks HIF from doing its job. When diabetic mice were given this drug before their blood sugar was lowered, their HIF levels stayed low.
As a result, the drug stopped the chain reaction and prevented the breakdown of the blood-retinal barrier. This means the drug may be able to stop the eye damage from happening.
Dr. Akrit Sodhi, the lead researcher on the study, says the findings help explain why some diabetes patients who try to tightly control their blood sugar—or who experience big swings between low and high blood sugar—can actually see their eye disease get worse.
He says targeting the HIF protein may be a good way to stop or treat diabetic eye problems in the future.
The researchers are planning more studies to learn even more about HIF, the eye’s protective barrier, and how 32-134D might help. They hope to test the drug in people with diabetic retinopathy in future clinical trials.
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.
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