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No association between thiazolidinedione exposure and DME
11 March 2010
MedWire News: Exposure to thiazolidinediones is not associated with increased risk for diabetic macular edema (DME) in patients with Type 2 diabetes, suggest study results.
“A small number of case reports have raised the possibility that use of thiazolidinediones, which can cause fluid retention, generally, might exacerbate DME,” explain Walter Ambrosius (Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA) and colleagues.
“These observations led to physician alerts or label changes by manufacturers in Canada and the United States.”
The team therefore investigated the association further in a group of 3473 patients with Type 2 diabetes enrolled in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial who had standardized fundus photos taken to assess DME and retinopathy status during 2003–2006.
Of the group, 695 (20.0%) patients had used thiazolidinediones and 217 (6.2%) had DME.
Writing in the Archives of Ophthalmology, the team reports that no significant association between thiazolidinedione exposure and DME was found in unadjusted or adjusted analyses (odds ratios=1.01 and 0.97, respectively).
Of note, more severe retinopathy and older age were associated with increased risk for DME, but glycated hemoglobin, duration of diabetes, gender, and ethnicity were not.
The researchers say that despite the lack of association seen in this study between thiazolidinedione use and DME they “cannot rule out the possibility of either a modest protective or deleterious association of thiazolidinedione exposure with DME.”
They add: “A more definitive answer may be provided from the 4-year follow-up data, which will enable us to examine prospectively the relationship between thiazolidinedione exposure and DME incidence.”
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