Common Medications and Diabetic Macular Edema

🎙️ Podcast Overview

• Episode Title: Common Medications and Diabetic Macular Edema
• Guests: Jawad Muayad (Texas A&M) and Dr. Sami S. Dahr (UT Health Sciences Center)
• Host: Dr. Drew Carey (Johns Hopkins Wilmer Eye Institute)
• Journal Article Discussed: “Influence of Common Medications on Diabetic Macular Edema in Type 2 Diabetes Mellitus” (Ophthalmology Retina, Vol. 9, Issue 6)

🧪 Study Focus

• Investigated the impact of systemic medications on the risk of developing DME in patients with type 2 diabetes.
• Medications studied:
  • GLP-1 receptor agonists
  • Fenofibrates
  • Thiazolidinediones (glitazones)
  • Calcium channel blockers

📊 Methodology

• Used the TriNetX database for comprehensive EHR access across institutions.
• Inclusion criteria:
  • Type 2 diabetics newly initiated on one of the four medications
  • No prior diabetic eye disease
  • Minimum five-year diabetes history
  • At least two follow-up prescriptions
• Propensity score matching for:
  • A1C levels
  • Diabetes complication severity index
  • Medication-specific indications

📈 Key Findings

💡 Clinical Implications

• Calcium channel blockers: May warrant reconsideration or closer monitoring in DME patients.
• GLP-1s: Despite FDA label warnings, may offer protective effects over time.
• Practice Change: Dr. Dahr now reviews systemic medications in suboptimal anti-VEGF responders and may recommend changes.

🔍 Future Directions

• Prospective trials to assess whether GLP-1s improve response to anti-VEGF therapy.
• Explore complex medication interactions (e.g., glitazones with insulin).

🗓️ Upcoming Events

• Virtual Journal Club: August 27, 2025 — discussion on GLP-1 use in non-diabetic patients and glaucoma risk.
• AAO 2025 Illuminate Event: October 18, 2025 — social gathering supporting ophthalmic education.