Diabetic Patients with Rosacea at Increased Risk of Ocular Disease

Chau Yee Ng, MD

A new database study found that patients with diabetes and rosacea were at a significantly higher risk of diabetic macular edema, glaucoma with medical treatment, dry eye disease, and cataract surgery compared to patients without rosacea.

In previous research, rosacea has been associated with a variety of systemic comorbidities including gastrointestinal, cardiovascular, neurologic, psychiatric, and metabolic diseases.

Diabetes has also been associated with several ocular diseases, with previous research suggesting a systemic inflammatory component. Though the role of inflammation in diabetic eye diseases has been studied, no research has been conducted regarfing ocular complications in patient with diabetes due to rosacea.

Investigators led by Chau Yee Ng, MD, Chang Gung Memorial Hospital, Taiwan, detailed the association between rosacea and eye diseases in patients with diabetes via a retrospective cohort nationwide study.

Ng and colleagues included all patients diagnosed as having diabetes mellitus who received hypoglycemic agents between January 1, 1997, and December 31, 2013.

A total of 2,099,303 patients were identified, 5459 of whom had been diagnosed with rosacea. After applying exclusions criteria, 4096 diabetic patients with rosacea were matched 1:4 with 16,384 diabetic patients without rosacea.

From there, investigators compared the risk of time-to-event outcome between rosaces and non-rosacea groups in the propensity score matching cohort using the Fine and Gray sub-distribution hazard model.

Following a mean follow-up period of 5 years, investigators observed that patients with diabetes and rosacea had significantly higher risks of diabetic macular edema (sub-distribution hazard ratio [SHR]: 1.31, 95% CI: 1.05-1.63), glaucoma with medical treatment (SHR: 1.11, 1.01-1.21), dry eye disease (SHR: 1.55, 1.38-1.75), and cataract surgery (SHR: 1.13, 1.02- 1.25) compared with patients without rosacea.

Additionally, the team observed a significant association between psoriasis, irritable bowel syndrome, anxiety, and depression in patients with diabetes and rosacea compared to patients without rosacea.

“In this retrospective cohort nationwide database study, diabetic patients with rosacea had significantly higher risks of diabetic macular edema, glaucoma with medical treatment, dry eye disease, and cataract surgery compared with patients without rosacea,” the team wrote. “This is the first study demonstrating the association.”

The findings were presented at the American Academy of Dermatology (AAD) 2022 Annual Meeting in Boston.