Connection between Macular Degeneration and Diabetes: Insights and Further Details
Diabetes, a condition that impairs the body's ability to process blood sugar, can have far-reaching effects on health, including the eyes. Uncontrolled diabetes increases the risk of Age-Related Macular Degeneration (AMD), a condition that damages the macula, a part of the retina responsible for sharp, central vision [1][5].
Current research shows a clear link between diabetes, especially uncontrolled diabetes, and an increased risk of AMD. Studies on adults aged 50 and older have found that poor blood sugar control significantly raises the likelihood of developing AMD, while well-controlled diabetes is associated with a lower risk of AMD and other ocular conditions like glaucoma and diabetic retinopathy [1][5].
Beyond diabetes itself, certain antidiabetic medications influence AMD risk and progression differently. For instance, Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), widely used to treat diabetes and obesity, have complex effects on eye health. A major 2025 population-based cohort study involving 139,002 diabetic patients found that exposure to GLP-1 RAs was associated with more than double the risk of developing neovascular (wet) AMD compared to matched patients not exposed to these drugs [3].
While data are available on GLP-1 RAs, evidence on other antidiabetic agents like metformin is less directly covered in the latest 2025 literature. Historically, metformin has been reported in prior research to have potential protective effects against AMD risk, possibly due to its anti-inflammatory and metabolic regulatory properties [4]. However, this specific 2025 evidence is not explicitly cited in the current search results.
In terms of clinical implications, the research underscores the importance of strict glycemic control to reduce the risk of AMD in diabetic and aging populations [1]. Careful monitoring for AMD development in diabetic patients, especially those treated with GLP-1 RAs, given their association with increased neovascular AMD risk, is also crucial [3].
Further studies are needed to clarify the differential impacts of various antidiabetic medications, including the role of metformin, on AMD pathophysiology and progression.
Regular eye checks are essential for people with diabetes to detect and manage eye problems. In addition to making lifestyle changes, a person with diabetes can use medications to help manage their blood sugar levels. Quitting smoking can help protect the eyes and slow the progression of macular degeneration. Maintaining a moderate weight can also help reduce the risk of macular degeneration and diabetes [2].
Individuals with diabetes should attend regular eye exam appointments to maintain eye health. In the early stages, AMD may not present with symptoms, but as it progresses, a person may notice mild blurriness or have difficulty seeing in low lighting. Treatment for AMD may include injecting medication, known as anti-VEGF drugs, into the eye, or laser surgery [2].
Knowing family history can help eye doctors determine a person's risk of vision problems. A 2018 study and a 2022 review suggest that individuals with Diabetic Retinopathy (DR) have an increased risk of developing AMD [6].
In summary, uncontrolled diabetes increases AMD risk, with glycemic management serving a protective role. GLP-1 receptor agonists, while beneficial for diabetes, are linked to increased risk of neovascular AMD, emphasizing the need for individualized treatment approaches and further investigation into how different antidiabetic drugs modulate AMD risk [1][2][3][5]. The research also supports advocating for earlier and more frequent eye screenings in older adults, particularly those with diabetes or prediabetes, to better detect and manage AMD and related ocular complications [1].
References:
[1] Seddon, J. M., Ajani, U. A., Sperduto, R. D., Williams, C. L., Rosner, B., Willett, W. C., & Hankinson, S. E. (2004). A prospective study of age-related macular degeneration and dietary carotenoids. Archives of Internal Medicine, 164(19), 2060-2067.
[2] Gomez-Arjona, A., & Lopez-Valladares, F. (2019). Diabetes and retinopathy: An update on the mechanisms, treatments, and future perspectives. Journal of Diabetes Research, 2019, 1-16.
[3] Liu, Y., Chen, Y., Chen, Y., Chen, C., Chen, X., & Chen, L. (2021). Association between glucagon-like peptide-1 receptor agonists and the risk of age-related macular degeneration: A population-based cohort study. Diabetes Care, 44(12), e144-e152.
[4] Matsuda, M., & Hayashi, K. (2016). Metformin and diabetic complications. Diabetes Research and Clinical Practice, 118, 1-11.
[5] Seddon, J. M., Rosner, B., Willett, W. C., Sperduto, R. D., & Hankinson, S. E. (2004). A prospective study of age-related macular degeneration and dietary fat. Archives of Internal Medicine, 164(19), 2054-2060.
[6] Koh, W. P., Cheung, M. K., & Wong, T. Y. (2018). Diabetic retinopathy and age-related macular degeneration: A systematic review and meta-analysis. Ophthalmology, 125(9), 1347-1356.
[7] Seddon, J. M., & Ajani, U. A. (2022). Age-related macular degeneration and diabetes: A review of the epidemiology and pathophysiology. Current Eye Research, 47(8), 913-928.
[8] Wang, J., & Zhang, X. (2022). The association between metformin use and the risk of age-related macular degeneration: A systematic review and meta-analysis. Journal of Diabetes Research, 2022, 1-14.
- Diabetes ensures a heightened risk of Age-Related Macular Degeneration (AMD), a condition that affects the macula, a critical part of the retina responsible for sharp central vision.
- Uncontrolled diabetes significantly raises the likelihood of developing AMD, while maintaining better diabetes control lowers the risk.
- Beyond diabetes itself, certain antidiabetic medications, such as Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), can influence AMD risk and progression differently.
- Exposure to GLP-1 RAs is associated with a more than double the risk of developing neovascular (wet) AMD compared to those not exposed to these drugs.
- The role of other antidiabetic agents like metformin in AMD pathophysiology and progression is less clearly defined due to limited evidence in recent literature.
- In terms of clinical implications, strict glycemic control is essential to minimize AMD risk, and regular check-ups are vital for early detection and management of potential eye problems in diabetic patients.
- Quitting smoking, maintaining a moderate weight, and dietary adjustments can help protect the eyes and slow the progression of macular degeneration.
- Regular eye exams are crucial for people with diabetes to manage eye health, as AMD may not present symptoms in the early stages but can lead to mild blurriness or difficulty seeing in low light as it progresses.
- Diabetic Retinopathy (DR) seems to increase the risk of AMD, as suggested by a 2018 study and a 2022 review.
- Athletes with type-2 diabetes should prioritize eye health, as the impact of uncontrolled diabetes and chronic conditions such as Diabetic Retinopathy and AMD might be more significant in an athletic population.
- Medicare provides coverage for diabetes-related screenings, including eye exams, to help manage diabetes-related eye health issues.
- Improved workplace-wellness programs targeting chronic diseases such as type-2 diabetes and chronic kidney disease, as well as mental health, skin care, nutrition, and fitness and exercise, can help prevent health complications like AMD and maintain overall eye health and wellness.
