PONE-D-19-23998

The impact of diabetes mellitus medication on the incidence of endogenous endophthalmitis

PLOS ONE

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Reviewer #1: Partly

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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Yes

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5. Review Comments to the Author

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Reviewer #1: In this manuscript, Chien et al. describe the results of a matched cohort study of the incidence of endogenous endophthalmitis (EE) among patients diagnosed with diabetes mellitus (DM). The objective was to determine whether treatment of diabetes is associated with a lower incidence of EE. The authors evaluated 121,800 patients with DM. Among these patients, 24,360 were treated with medication, and 97,440 were not. Single-agent therapy with insulin, metformin, gliclazide, glimepiride, or repaglinide and combination therapy with glimepiride/metformin or repaglinide/metformin were associated with a decreased risk of EE. Neither sex nor age influenced risk, however those patients with liver abscesses were at increased risk relative to patients without liver abscesses. There are a number of issues with this manuscript. The first is that no information was provided on patient diagnosis such as A1C levels or whether the patients were type 1 or 2. Second, it also is not clear why so many patients with diabetes were not being treated. Were they all under dietary control for diabetes, or were they without medication due to lack of compliance or lack of medical care? Finally, the authors were not clear on their rationale for performing this study. Indeed, diabetes mellitus is an underlying risk factor for developing endogenous endophthalmitis, however they were vague in describing the mechanism for this. Another group has demonstrated that this correlation is likely due to the break down of the blood retinal barrier during diabetes development and progression to diabetic rertinopathy, and likely has little to do with keratitis.

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The impact of diabetes mellitus medication on the incidence of endogenous endophthalmitis

PONE-D-19-23998R1

Dear Dr. Weng,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

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Andrew W Taylor, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

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Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: (No Response)

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: (No Response)

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: (No Response)

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

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Reviewer #1: No