Corneal Confocal Microscopy Identifies People with Type 1 Diabetes with More Rapid Corneal Nerve Fibre Loss and Progression of Neuropathy

Alam, Uazman ORCID: 0000-0002-3190-1122, Ponirakis, Georgios, Asghar, Omar, Petropoulos, Ioannis N, Azmi, Shazli, Jeziorska, Maria, Marshall, Andrew ORCID: 0000-0001-8273-7089, Boulton, Andrew JM, Efron, Nathan and Malik, Rayaz A (2022) Corneal Confocal Microscopy Identifies People with Type 1 Diabetes with More Rapid Corneal Nerve Fibre Loss and Progression of Neuropathy. JOURNAL OF CLINICAL MEDICINE, 11 (8). 2249-.

Access the full-text of this item by clicking on the Open Access link.

Text Corneal Confocal Microscopy Identifies People with Type 1 Diabetes with More Rapid Corneal Nerve Fibre Loss and Progression .pdf - Published version Download (1MB) | Preview

Abstract

There is a need to accurately identify patients with diabetes at higher risk of developing and progressing diabetic peripheral neuropathy (DPN). Fifty subjects with Type 1 Diabetes Mellitus (T1DM) and sixteen age matched healthy controls underwent detailed neuropathy assessments including symptoms, signs, quantitative sensory testing (QST), nerve conduction studies (NCS), intra epidermal nerve fiber density (IENFD) and corneal confocal microscopy (CCM) at baseline and after 2 years of follow-up. Overall, people with type 1 diabetes mellitus showed no significant change in HbA1c, blood pressure, lipids or neuropathic symptoms, signs, QST, neurophysiology, IENFD and CCM over 2 years. However, a sub-group (<i>n</i> = 11, 22%) referred to as progressors, demonstrated rapid corneal nerve fiber loss (RCNFL) with a reduction in corneal nerve fiber density (CNFD) (<i>p</i> = 0.0006), branch density (CNBD) (<i>p</i> = 0.0002), fiber length (CNFL) (<i>p</i> = 0.0002) and sural (<i>p</i> = 0.04) and peroneal (<i>p</i> = 0.05) nerve conduction velocities, which was not related to a change in HbA1c or cardiovascular risk factors. The majority of people with T1DM and good risk factor control do not show worsening of neuropathy over 2 years. However, CCM identifies a sub-group of people with T1DM who show a more rapid decline in corneal nerve fibers and nerve conduction velocity.

Item Type:	Article
Uncontrolled Keywords:	diabetic peripheral neuropathy (DPN), corneal confocal microscopy (CCM), Intra-epidermal nerve fiber density (IENFD), nerve conduction studies (NCS)
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	30 Jun 2022 15:02
Last Modified:	18 Jan 2023 20:56
DOI:	10.3390/jcm11082249
Open Access URL:	https://www.mdpi.com/2077-0383/11/8/2249
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3157446

Available Versions of this Item

• Corneal Confocal Microscopy Identifies People with Type 1 Diabetes with More Rapid Corneal Nerve Fibre Loss and Progression of Neuropathy. (deposited 06 May 2022 15:21)
  • Corneal Confocal Microscopy Identifies People with Type 1 Diabetes with More Rapid Corneal Nerve Fibre Loss and Progression of Neuropathy. (deposited 30 Jun 2022 15:02) [Currently Displayed]