Fasting Plasma Sugar: A Predictor of Accommodative Function in Diabetes.

Background: Diabetes has been associated with decline in accommodative function in some ethnic groups. This outcome, however, could differ since ethnic variations in accommodation have been noted. This study investigated the relationship between plasma sugar level on subjective accommodative amplitude and accommodative lag in black Africans with type-1 diabetes.

Methods: An examiner-blind study of subjective accommodative amplitude and accommodative lag between 45 diabetic subjects (15 males, 30 females) aged 12-39 years and 45 age- and sex-matched healthy non-diabetic controls was conducted. Accommodative amplitude was measured by the push-up to blur/push-down to clear methods using a RAF rule, the accommodative lag by the MEM retinoscopy, and the fasting plasma sugar (FPS) by a glucose meter.

Results: Comparatively, the diabetic subjects had significantly lower accommodative amplitude (10.1 ± 2.7 D versus 11.5 ± 2.4 D, respectively; p = 0.010) and greater accommodative lag (1.1 ± 0.4 D versus 0.7 ± 0.2 D; p < 0.001, respectively) than the controls. Multiple regression analyses showed that after adjusting for age, FPS concentration significantly predicted accommodative amplitude (R(2 )= 0.05, p = 0.022) and accommodative lag (R(2 )= 0.30, p < 0.001) in diabetes. Duration of diabetes was not significantly related to accommodative amplitude and accommodative lag.

Conclusion: Diabetes mellitus in black Africans was associated with lower accommodative amplitude and greater accommodative lag. An adequate control of the plasma sugar concentration may be vital to maintain proper accommodative function.