New research has found that hypoglycaemia can worsen diabetic retinopathy by damaging the blood-retina barrier.
A study, published in Science Translational Medicine, revealed that diabetic mice in induced periods of low sugar were impacted by a build up of a protein known as hypoxia-inducible factor (HIF), which leads to overgrowth and leakage of blood vessels in the retina.
An experimental drug known as 32-134D, which inhibits the HIF protein, has also been tested with positive results, and researchers intend to pursue further studies to HIF and conduct clinical studies of 32-134D in patients with diabetic retinopathy.
‘These studies help explain why patients with diabetes who are initially started on tight glucose control, the cornerstone of diabetic management, or those who have high glycemic variability (transient episodes of very low — followed by very high — serum glucose levels), experience worsening of their diabetic eye disease.
‘Our findings underscore why therapies targeting HIF will be an effective approach to prevent or treat diabetic retinopathy,’ said corresponding author Akrit Sodhi, associate professor of ophthalmology and the Branna and Irving Sisenwein Professor of Ophthalmology at the Johns Hopkins University School of Medicine and the Wilmer Eye Institute.