title: Ocular surface changes in patients treated with oral antidiabetic drugs or insulin.
abstract: OBJECTIVE
  To describe and compare ocular surface changes in patients with type 2 diabetes treated with either oral antidiabetic drugs (OAD) or insulin.
  
  
  METHODS
  Forty eyes of 20 patients treated with OAD, 40 eyes of 20 patients treated with insulin, and 10 nondiabetic controls seen at Ministry of Health Ankara Educational and Research Hospital, 1st Eye Clinic, were studied. All subjects underwent routine ophthalmic examinations, Schirmer test, tear film break-up time analysis, and conjunctival impression cytologic analysis. Patients treated with OAD or insulin and a control group were compared for tear function parameters, goblet cell density, and squamous metaplasia grade. The relation between status of retinopathy and ocular surface disorder and serum HbA1c levels of diabetic patients were also noted.
  
  
  RESULTS
  The tear film break-up time values were significantly lower in patients treated with OAD (p&lt;0.05). There was no statistically significant difference in Schirmer test results of the 3 groups. Goblet cell density and squamous metaplasia grade were similar in all groups. The median grade was grade 1, in which epithelial cells are slightly larger, more polygonal, have eosinophilic staining cytoplasm, and goblet cells are decreased in number. Status of retinopathy did not seem to relate to ocular surface disorder. The serum HbA1c level of diabetic patients treated with insulin or OAD was similar (p&gt;0.05).
  
  
  CONCLUSIONS
  Precorneal tear film stability was worse in patients treated with OAD; however, impression cytology analysis and Schirmer test results were similar in all groups.
authors.affiliation: Eye Clinic, Sakarya Educational and Research Hospital, Sakarya - Turkey.
authors.forename: Burçin Köklü
authors.initials: BK
authors.lastname: Çakır
authors.affiliation: Eye Clinic, Ankara Educational and Research Hospital, Ankara - Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Katırcıoğlu
authors.affiliation: Eye Clinic, Ankara Educational and Research Hospital, Ankara - Turkey.
authors.forename: Nurten
authors.initials: N
authors.lastname: Ünlü
authors.affiliation: Eye Clinic, Ankara Educational and Research Hospital, Ankara - Turkey.
authors.forename: Sunay
authors.initials: S
authors.lastname: Duman
authors.affiliation: Pathology Clinic, Ankara Educational and Research Hospital, Ankara - Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Üstün
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002452:Cell Count; D003228:Conjunctiva / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004847:Epithelial Cells / Q000187:drug effects*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D020397:Goblet Cells / Q000187:drug effects*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D013194:Staining and Labeling; D013666:Tears / Q000378:metabolism
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human