Progressive loss of corneal nerve fibers is associated with physical inactivity and glucose lowering medication associated with weight gain in type 2 diabetes. Issue 10 (20th June 2022)

• Record Type: Journal Article
• Authors: Ponirakis, Georgios; Al‐Janahi, Ibrahim; Elgassim, Einas; Gad, Hoda; Petropoulos, Ioannis N; Khan, Adnan; Ali, Hamda; Siddique, Mashhood A; Gul, Wajiha; Ferdousi, Maryam; Kalteniece, Alise; Mohamed, Fatima FS; Ahmed, Lina HM; Dakroury, Youssra; El Shewehy, Abeer MM; Al‐Mohamedi, Abdulrahman; AlMarri, Fatema; Homssi, Moayad; Qazi, Murtaza; Hadid, Nebras H; Al‐Khayat, Fatima; Mahfoud, Ziyad R; Azmi, Shazli; Alam, Uazman; Zirie, Mahmoud A; Al‐Ansari, Yousuf; Jayyousi, Amin; Rigby, Alan S; Kilpatrick, Eric S; Atkin, Stephen L; Malik, Rayaz A;
• Is Part Of: Journal of diabetes investigation. Volume 13:Issue 10(2022)
• Page Start: 1703
• Page End: 1710
• Publication Date: 2022-06-20
• Subjects: Corneal confocal microscopy -- Diabetic neuropathy -- Physical inactivity; Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.13864
• Languages: English
• ISSNs: 2040-1116

Abstract

Abstract: Aims/Introduction: Limited studies have identified risk factors linked to the progression of diabetic peripheral neuropathy (DPN) in type 2 diabetes. This study examined the association of risk factors with change in neuropathy measures over 2 years. Materials and Methods: Participants with type 2 diabetes ( n = 78) and controls ( n = 26) underwent assessment of clinical and metabolic parameters and neuropathy using corneal confocal microscopy (CCM), vibration perception threshold (VPT), and the DN4 questionnaire at baseline and 2 year follow‐up. Results: Participants with type 2 diabetes had a lower corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) ( P ≤ 0.0001) and a higher VPT ( P ≤ 0.01) compared with controls. Over 2 years, despite a modest reduction in HbA1c ( P ≤ 0.001), body weight ( P ≤ 0.05), and LDL ( P ≤ 0.05) the prevalence of DPN ( P = 0.28) and painful DPN ( P = 0.21) did not change, but there was a significant further reduction in CNBD ( P ≤ 0.0001) and CNFL ( P ≤ 0.05). CNFD, CNBD, and CNFL decreased significantly in physically inactive subjects ( P < 0.05–0.0001), whilst there was no change in CNFD ( P = 0.07) or CNFL ( P = 0.85) in physically active subjects. Furthermore, there was no change in CNFD ( P = 0.82), CNBD ( P = 0.08), or CNFL ( P = 0.66) in patients treated with glucose lowering medication associated with weight loss, whilst CNBD ( P = 0.001) decreased in patients on glucose lowering medication associated with weight gain. Conclusions: In participants with type 2 diabetes, despite a modest improvement in HbA1c, body weight, and LDL there was a progressive loss of corneal nerve fibers; except in those who were physically active or on glucose lowering medication associated with weight loss.