Which hyperosmotic agent is preferred for treating diabetic patients?

In the context of treating diabetic patients with hyperosmotic agents, isosorbide is often preferred due to its properties and the specific needs of diabetic management. Isosorbide is a sugar alcohol that can effectively draw fluid out of the eye, reducing intraocular pressure without the risk of significant glucose fluctuations, which is crucial for diabetic patients.

Diabetic patients often have concerns about hyperglycemia, and since isosorbide does not contribute to glucose levels, it presents a safer alternative compared to agents like glycerin. While glycerin is effective as a hyperosmotic agent, it can increase blood glucose levels, which would be undesirable in a diabetic patient. Muro 128, which contains sodium chloride, is primarily used in conditions like corneal edema rather than for intraocular pressure reduction in diabetic patients. Fluorescein, on the other hand, is used for diagnostic purposes rather than as a treatment for managing intraocular pressure.

Choosing isosorbide for hyperosmotic therapy in diabetic patients aligns with considerations of efficacy and patient safety, making it the preferred option among the choices available.