Abstract

AIM To determine the incidence of self reported glaucoma in a group of people with diabetes mellitus.

METHODS In an 11 county area in southern Wisconsin, a cohort of people with diabetes mellitus was identified and characterised by history, physical examination, fundus photographs, and laboratory evaluation in 1980–2 (n=2366). The cohort was followed for 10 years with 891 younger onset and 987 older onset people participating in at least one follow up examination.

RESULTS The 10 year incidence of glaucoma was 3.7% in younger onset people, 6.9% in older onset people not using insulin, and 11.8% in older onset people using insulin. Univariate analyses revealed that in younger onset people greater body mass index, older age, longer duration of diabetes, history of cataract surgery, and increased severity of diabetic retinopathy at baseline conferred increased risk. In older onset people using insulin, older age and longer duration of diabetes, higher intraocular pressure, and history of cataract surgery at baseline were associated with increased risk of glaucoma. In multivariate analyses, only age was significantly related to increased incidence in younger onset people and age, intraocular pressure, and insulin use were significantly associated with increased risk in the older onset group.

CONCLUSION Most risk factors associated with self reported glaucoma in people with diabetes cannot currently be modified to decrease incidence. Older onset people who are at increased risk of many ocular complications of diabetes may be particularly in need of specialised ophthalmic observation.