CT Morphology Of The Lacrimal Gland In Type 2 Diabetic Patients Compared With The Normal Population And Its Clinical Significance

BackgroundDiabetes is a prevalent metabolic disorder that is witnessing a rising trend of incidence globally.This disease has the potential to alter the structural and functional properties of the lacrimal glands,which can lead to the onset of diabetes-related dry eye.Hence,investigating the effects of diabetes on the lacrimal glands through imaging studies can not only deepen our understanding of diabetes-related dry eye,but also enhance the quality of life for individuals suffering from diabetes.ObjectiveComparison of Lacrimal Gland CT Morphology between Type 2 Diabetes Patients and Normal Population and its Clinical Significance.MethodsA retrospective analysis was conducted on 340 head and neck CT angiography examinations,including 109 patients with type 2 diabetes and 231 non-diabetic individuals.The participants were divided into groups based on various characteristics,such as gender(215 males and 125 females),age(30 individuals aged 0-40 years,146 individuals aged 40-60 years,and 164 individuals aged 60 years or older),diabetes status(109 with type 2 diabetes and 231 without diabetes),glucose control(36 individuals with HbAlc<6.5%,73 individuals with HbAlc≥6.5%),duration of diabetes(31 individuals with 1-5 years of diabetes,37 individuals with 510 years of diabetes,32 individuals with 10-20 years of diabetes,and 9 individuals with more than 20 years of diabetes),and treatment for diabetes(96 individuals receiving oral medication and 13 individuals receiving a combination of oral medication and insulin).The differences in tear gland CT morphology(tear gland length,short axis,and cross-sectional area)were then compared among the group.ResultsThe results of this study showed that the length and cross-sectional area of the lacrimal gland decreased as age increased,with statistical significance(P<0.05).A negative correlation was found between age and the lacrimal gland length and crosssectional area(r=-0.293,P<0.001;r=-0.256,P<0.01).There was no significant difference in lacrimal gland size based on gender(both P>0.05).However,there was a significant difference in lacrimal gland size between the type 2 diabetes group and the non-diabetes group(P<0.05).Additionally,the short diameter and cross-sectional area of the lacrimal gland showed significant differences between the HbA1c<6.5%and HbA1c≥6.5%groups(P<0.05),with a negative correlation found between HbAlc and lacrimal gland short diameter and cross-sectional area(r=-0.282,P<0.05;r=-0.215,P<0.05).The cross-sectional area of the lacrimal gland was also found to decrease as diabetes duration increased,with statistical significance(P<0.05).A negative correlation was found between diabetes duration and lacrimal gland length,short diameter,and cross-sectional area(r=-0.275,P<0.05;r=-0.191,P<0.05;r=-0.333,P<0.001).Finally,there were significant differences in lacrimal gland length between the oral medication group and the insulin and oral medication group.Conclusion1.Reduction in the volume of the lacrimal gland may be one of the pathogenic mechanisms of diabetes-associated dry eye;2.Better control of blood glucose has a positive effect on preventing reduction in the volume of the lacrimal gland and delaying the development of diabetes-associated dry eye;3.Patients with diabetes duration of more than 10 years are at increased risk of developing reduction in the volume of the lacrimal gland leading to diabetesassociated dry eye;4.The protective effect of treatment regimens with the addition of insulin on the lacrimal gland needs further study.