Progressive loss of corneal nerve fibers is associated with physical inactivity and glucose lowering medication associated with weight gain in type 2 diabetes.pdf (373.46 kB)
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Progressive loss of corneal nerve fibers is associated with physical inactivity and glucose lowering medication associated with weight gain in type 2 diabetes

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posted on 21.11.2022, 12:13 authored by Georgios Ponirakis, Ibrahim Al-Janahi, Einas Elgassim, Hoda Gad, Ioannis N Petropoulos, Adnan Khan, Hamda Ali, Mashhood A Siddique, Wajiha Gul, Maryam Ferdousi, Alise Kalteniece, Fatima FS Mohamed, Lina HM Ahmed, Youssra Dakroury, Abeer MM El Shewehy, Abdulrahman Al-Mohamedi, Fatema AlMarri, Moayad Homssi, Murtaza Qazi, Nebras H Hadid, Fatima Al-Khayat, Ziyad R Mahfoud, Shazli Azmi, Uazman Alam, Mahmoud A Zirie, Yousuf Al-Ansari, Amin Jayyousi, Alan S Rigby, Eric S Kilpatrick, Stephen AtkinStephen Atkin, Rayaz A Malik

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.

Funding

Qatar National Research Fund, Funding ID: BMRP-5726113101

Qatar National Research Fund, Funding ID: NPRP8-315-3-065

History

Comments

The original article is available at https://onlinelibrary.wiley.com/

Published Citation

Ponirakis G. et al. Progressive loss of corneal nerve fibers is associated with physical inactivity and glucose lowering medication associated with weight gain in type 2 diabetes. J Diabetes Investig. 2022;13(10):1703-1710.

Publication Date

2 June 2022

PubMed ID

35652859

Department/Unit

  • RCSI Bahrain

Publisher

Asian Association for the Study of Diabetes and Blackwell Pub.

Version

  • Published Version (Version of Record)