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Published: 2015-03-30

Insulin Use and Risk of Diabetic Macular Edema in Diabetes Mellitus: A Systemic Review and Meta-Analysis of Observational Studies

Jun Zhang, Jingxue Ma, Nalei Zhou, Bin Zhang, Jianbin An

(Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland))

Med Sci Monit 2015; 21:929-936

DOI: 10.12659/MSM.892056


Abstract: Background: Diabetes mellitus is a common and serious disorder. A search of the literature reveals no comprehensive quantitative assessment of the association between insulin use and incidence of diabetic macular edema. Therefore, we performed a meta-analysis of observational studies to evaluate the effect of insulin use on the risk of developing macular edema.
Material/Methods: Comparative studies published until May 2014 were searched through a comprehensive search of the Medline, Embase, and the Cochrane Library electronic databases. A systematic review and quantitative analysis of comparative studies reporting the effect of insulin use on the incidence of macular edema was performed. All analyses were performed using the Review Manager (RevMan) v.5 (Nordic Cochrane Centre, Copenhagen, Denmark).
Results: A total of 202 905 individuals were included in the present meta-analysis. In a random-effects meta-analysis, the use of insulin was found to be associated with increased risk of macular edema (RR, 3.416; 95% CI, 2.417–4.829; I2, 86.6%). Analysis that just included high-quality studies showed that insulin use increased the risk of macular edema (RR, 2.728; 95% CI, 1.881–3.955; I2=77.7%). In cohort studies (RR, 4.509; 95% CI, 3.100–6.559; I2, 77.7%) but not in case-control studies (RR, 1.455; 95% CI, 0.520 to 4.066; I2, 95.9%), increased incidence of macular edema was observed.
Conclusions: The results of this meta-analysis of observational studies demonstrate that insulin use is a risk factor for diabetic macular edema. However, available data are still sparse, and in-depth analyses of the assessed a... read more

Keywords: Case-Control Studies, Cohort Studies, Insulins, Insulins, Macular edema, meta-analysis




Published: 2015-03-29

Epidural Analgesia with Amide Local Anesthetics, Bupivacaine, and Ropivacaine in Combination with Fentany...


Yiyang Li, Cong Hu, Yanyan Fan, Huixia Wang, Hongmei Xu

Med Sci Monit 2015; 21:921-928

DOI: 10.12659/MSM.892276

Published: 2015-03-28

miR-191 Modulates Malignant Transformation of Endometriosis Through Regulating TIMP3


Mei Dong, Piyong Yang, Fang Hua

Med Sci Monit 2015; 21:915-920

DOI: 10.12659/MSM.893872