Association of Meibomian Gland Dysfunction Severity and Glycohemoglobin Levels in Type 2 Diabetic Patients

Purpose: To investigate the association of meibomian gland dysfunction severity and glycated hemoglobin A (HbA1c) levels among type 2 diabetic patients. Patients and Methods: In this cross-sectional, 40 type 2 diabetic patients with meibomian gland dysfunction (MGD) were studied at Basir Eye Clinic, Tehran, Iran. An expert ophthalmologist determined the MGD stage based on staging scale outlined in American academy of ophthalmology's basic and clinical science course. The HbA1c level was measured applying a standard method, certified by the National Glycohemoglobin Standardization Program (NGSP). We divided patients to two groups based on their HbA1C level; the first group included patients with HbA1c < 6.5 % and the second group included patients with HbA1c ≥ 6.5 %.Results: Our results demonstrated that 12.5 % of the participants had minimal, 52.5 % had mild and 35 % had moderate to severe MGD. We observed that different levels of HbA1c (over or under 6.5 %) were significantly associated with MGD severity (P < 0. 013). Moderate to severe MGD stage was observed in 43.7 % of individuals with HbA1c ≥ 6.5 %, while it was found in none of participants with HbA1c < 6.5 %. With increase in HbA1c level, the risk of moderate to severe MGD occurrence increased (OR = 3.57; 95 % CI: 1.05-12.13; P = 0.041). This association was not confounded by age or gender. Conclusion: Meibomian gland dysfunction severity has an association with HbA1c levels in diabetic type 2 patients, and a rise in HbA1c noticeably aggravates the MGD stage.Keywords: Glycated hemoglobin A; Meibomian gland dysfunction; Diabetes mellitus; Dry eye syndromes; Diabetes