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Although the exact pathophysiology of NAION is unknown, it is understood to result from insufficient blood flow to the optic nerve head, the researchers wrote in their paper

Although meta-analysis (97 comparisons across 95 trials) demonstrated a statistically significant but clinically unimportant increase in FPG [fasting plasma glucose] (Hall et al., 2020), the impact of any diuretic on glucose homeostasis seems to depend on several factors, including the type of diuretic used and the specific metabolic context on which these diuretics are being studied (Grossman et al., 2011)

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There is a complex interaction between host genetic and metabolic makeup, diet, and microbiota (Figure 5)