Age and metabolic control influence lens opacity in type I, insulin-dependent diabetic patients

Cataract is a frequent ocular complication in diabetic patients, but few da ta are available concerning early modifications occurring in the lens of th ese patients and their relationship with metabolic control and other clinic al parameters. We measured lens opacity in 73 type I, insulin-dependent dia betic patients aging 50 years or less and without clinical evidence of cata ract, and in 46 healthy volunteers of similar age. We used a quick, simple, and reliable instrument, the Lensmeter 701, which is based on a back-light scattering quantification system and is able to quantify lens transparency along the nuclear axis. Mean lens opacity was significantly (p = 0.0001) h igher in diabetic patients than in the control group, and multiple regressi on analysis showed that it correlated with age (p = 0.0001) and HbA(1c) lev els(p = 0.009). Moreover in the younger group of patients (age less than or equal to 20 years) the only observed correlation was that with Hba(1c) (p = 0.03), whereas in the older ones (age 21-30 and > 30 years) lens opacity correlated with age (p = 0.02 and p = 0.01). These data indicate that early opacifications of the lens occur in type I, insulin-dependent diabetic pat ients and are influenced by the degree of the metabolic control in the youn ger ones, whereas the well-known role of aging on lens transparency became prevalent in the older patients. Only longitudinal studies, however, can de monstrate whether these alterations represent any early stage of cataractag enesis and the role of good metabolic control in preventing this ocular com plication. (C) 1999 Elsevier Science Inc.