Impact of Type 2 Diabetes Mellitus-Related Factors on Glaucoma: a Comprehensive Review

PurposeTo investigate the contradictory association of glaucoma with type 2 diabetes mellitus (T2DM) and its related factors that have been a springboard for a number of complications including glaucoma. Also, to examine the neuroprotective effects of antidiabetic medications.Recent FindingsRecent studies suggest that T2DM may alleviate glaucoma risk or they may have common risk factors. Further, antidiabetic medications also exhibited neuroprotective properties in several studies.SummaryGlaucoma is one of the complications significantly influenced by diabetes-induced metabolic changes in the body. Though the precise relationship between T2DM and glaucoma is still vague, various studies have aimed to investigate whether T2DM and its associated factors alleviate or aggravate glaucoma prognosis. These studies examined diverse aspects including anthropometric and demographic factors, lifestyle and dietary habits related to diabetes, in addition to genetics and antidiabetic medications, to establish their potential role in glaucoma risk, progression, and prevention. Despite numerous factors contributing to glaucoma progression, viz., loss of retinal ganglion cells, vision loss, etc., current antiglaucoma medications focus on reducing intraocular pressure. To bridge the existing gaps, other parameters must be addressed through interventions like lifestyle modifications, nutritional habits; or using antidiabetic drugs that are very likely protective against glaucoma incidence and progression. Additionally, genetic screening of high-risk individuals and glaucoma patients to assess drug response will greatly improve patient care. Thus, this review provides a comprehensive juxtaposition of both positive and negative implications of T2DM-associated factors in glaucoma to pave way for novel interventions and optimize patient outcomes in glaucoma management.