|Year : 1982 | Volume
| Issue : 4 | Page : 367-369
Tear glucose in uncontrolled and chemical diabetics
MS Gaur, GK Sharma, SG Kabra, PK Sharma, LK Nepalia
Deptt. of Ophthalmology, Anatomy and Biochemistry, J.L.N. Medical College, Ajmer, India
G K Sharma
Department of Ophthalmology, J.L.N. Medica College, Ajmer
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gaur M S, Sharma G K, Kabra S G, Sharma P K, Nepalia L K. Tear glucose in uncontrolled and chemical diabetics. Indian J Ophthalmol 1982;30:367-9
The glucose in a diffusible but nonionized constituent of Lacrimal fluid. Since the pioneering work of Ridley several workers have attempted to quantitatively correlate the level of tear glucose with that of blood in diabetic states. However, these studies have been carried out on limited number of samples/ patients. Moreover, different researchers have employed different analytical procedures. This has resulted in confusing and even contradictory data as highlighted by Lewis and Stephens and Gasset, et al,. The present study is an attempt to comprehensively evaluate the same.
| Materials and methods|| |
The Subject matter of study comprised of fifty uncontrolled diabetics (40 of maturity onset and 10 of juvenile on) and twenty five cases of chemical diabetes from consecutive patients attending the clinic of the hospital Fifty age and sex matched non diabetic indoor patients of eye wards were studied as control.
Tear samples were collected by a capillary tube after inhalation of spirit of ammonia. Simultaneous blood and tear samples were collected while fasting, and three samples after
ingestion of 100 g of glucose at hr, ½ hr and 2 hr, intervals.
| Observations|| |
Statistical analysis of the results of blood and tear glucose levels in the three groups studied is presented in [Table - 1].
| Discussion|| |
The present study undertaken in different groups of diabetic and normal subjects have revealed that the level of glucose in Lacrimal fluid provides a faithful reflection of the level of blood glucose. A statistically significant positive correlation exists between the level of blood and tear glucose in normal subjects (p<0.01) in uncontrolled diabetes (p<0.001) and in chemical diabetes (p<0.001). The rise and fall in the level of tear glucose under the effect of 100g glucose lead is in strict conformity with the temporal changes in blood glucose level characteristic of the group. Thus an estimation of tear glucose may be employed as an equally acceptable and efficacious method for detecting and monitoring diabetes mellitus.
In chemical diabetes the fasting tear glucose value is 13.3 + 2.8 mg and the fasting blood glucose level is
71 ± 2.1 mg%. The fasting blood glucose level in this group is same as that of control, but the tear glucose is significantly (p<0.05) raised. According to Heward and Daubs this state of hyperglycodacryosis with normoglycaemia is probably the result of facilitated diffusion of glucose from blood to tissue fluids in presence of the inherent metabolic defects in chemical diabetics.
In the light of the present work the -estimation of tear glucose level assumes significance in the detection of diabetes, particularly so the chemical diabetes where the fasting tear glucose estimation reveals the diagnosis while the fasting blood glucose fails to do so.
| Summary|| |
The levels of blood and tear glucose, fasting and under glucose load, have been quantitatively estimated in 50 uncontrolled diabetics and 25 chemical diabetics and compared with 50 control subjects. The tear glucose levels bear statistically significant correlation with blood glucose levels in all the groups studied. It is concluded that tear glucose estimation is a simple and more efficacious method for detection of diabetes, particularly chemical diabetes.
| References|| |
Ridley, F., 1930, Brit. J. Exp. Pathol., 11 :217.
Lewls, J.C. and Stephens, P.J., 1958, Brit. J. Opthalmol. 42 : 754
Gasset, et at., 1968, Amer. J. Ophthalmol. 65: 414
Heward, J.D. (Jr.) and Daubs, J.G., 1975. J. Amer. Optom. Ass: 4611, 59.
[Table - 1]