Diabetes Linked to Higher Risk of Ulcerative Keratitis

Corneal ulcers may be more likely in diabetes patients because higher A1c levels predispose patients to impaired barrier function in the corneal epithelium; furthermore, such patients experience decreased corneal sensitivity and tear production. Photo: Suzanne Sherman, OD. Click image to enlarge. Ulcerative keratitis (UK) incidence reached its highest level in the final year of a seven-year study, and patients with diabetes, especially those with poor glycemic control, were at greater risk of developing the condition.To understand trends in corneal ulceration incidence, the authors evaluated data from the TriNetX medical database. They explained that they compared patients with and without diabetes “after propensity score matching for baseline demographic characteristics.”The incidence of ulcerative keratitis fluctuated throughout the study but generally increased, reaching a peak of “30.06 cases per 100,000 person-years in 2024,” as explained by the authors in the study. To further examine the diabetes-related risk, they matched cohorts with and without diabetes and followed them for one year. Diabetic patients had a 60% greater risk of developing UK than nondiabetic ones.Researchers also evaluated the impact of glycemic control and its association with UK development. Among patients with diabetes, those with recorded hemoglobin A1c levels above 8% faced a significantly higher risk of ulceration than those with values below 8%. They noted that pathophysiological mechanisms underlying DM can negatively affect corneal health,” suggesting that poor glycemic control could contribute to impaired wound healing, altered corneal innervation and increased susceptibility to infection and inflammation.The retrospective design and reliance on electronic health record data limited the ability to assess disease severity and causality; nevertheless, these findings pointed out the relevance of diabetes, particularly uncontrolled diabetes, as a significant risk factor for ulcerative keratitis and emphasized the importance of systemic disease management in preserving corneal health.Click here for the journal source. Inangolu S, Munir W. Incidence of Ulcerative Keratitis in the United States With and Without Predisposing Diabetes Mellitus. Eye Contact Lens. June 17, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.