ArticleDiabetes2014
Early detection of nerve fiber loss by corneal confocal microscopy and skin biopsy in recently diagnosed type 2 diabetes.
Article in Diabetes, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02423434 (Multinational Collaborative Evaluation of Corneal Confocal Microscopy as a Surrogate Endpoint for the Identification and Prediction of Diabetic Neuropathy in Type 1 Diabetes), which is not on this map. Cited by 151 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multinational Collaborative Evaluation of Corneal Confocal Microscopy as a Surrogate Endpoint for the Identification and Prediction of Diabetic Neuropathy in Type 1 Diabetes
Who cites it
151 citing papers in PubMed, 4 syntheses or guidelines pooled it, 311 citations in OpenAlex.
- Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta-analysis.Journal of diabetes investigation · 2022Pooled it
- Prevalence of peripheral neuropathy in pre-diabetes: a systematic review.BMJ open diabetes research & care · 2021Pooled it
- [Confocal microscope examination of the corneal nerve plexus as biomarker for systemic diseases : View from the corneal nerve plexus on diabetes mellitus disease].Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2017Pooled it
- A systematic review on the impact of diabetes mellitus on the ocular surface.Nutrition & diabetes · 2017Pooled it
- Comparison of intraepidermal nerve fiber density and confocal corneal microscopy for neuropathy.Annals of clinical and translational neurology · 2024Trial
- Trial
- Clinical neuropathy scales in neuropathy associated with impaired glucose tolerance.Journal of diabetes and its complications · 2015Trial
- A narrative review of what cohorts have taught us and how they have laid the foundation for much of our understanding of type 2 diabetes.Diabetologia · 2026Review
- Non-invasive biomarkers for diabetic complications: insights from corneal and retinal imaging.Acta diabetologica · 2026Article
- Safety and efficacy of keratorefractive surgery in diabetes mellitus: A clinical review.World journal of clinical cases · 2026Review
- Article
- Risk Factors Associated with Corneal Nerve Fiber Length Reduction in Patients with Type 2 Diabetes.Journal of clinical medicine · 2025Article
- Review
- Methods for the evaluation of corneal nerve fibres in diabetes mellitus by in vivo confocal microscopy: a scoping review.BMJ open · 2025Article
- In Vivo Confocal Microscopy of the Cornea in Diagnosing Small Fibre Neuropathy: A Cross-Sectional Observational Study.Diagnostics (Basel, Switzerland) · 2025Article
- Analysis of the correlation between corneal and meibomian gland morphology and glycated hemoglobin levels in type 2 diabetes patients.BMC ophthalmology · 2025Article
- Muscarinic Receptor Antagonism and TRPM3 Activation as Stimulators of Mitochondrial Function and Axonal Repair in Diabetic Sensorimotor Polyneuropathy.International journal of molecular sciences · 2025Review
- Changes Over 10 Years in Peripheral Nerve Function in People With Well-Controlled Type 2 Diabetes and Those With Normal Glucose Tolerance.Neurology · 2025Observational
- Differential Impact of Metabolic Factors and Comorbidities on Peripheral Neuropathy.Journal of the peripheral nervous system : JPNS · 2025Article
- Evaluation of Corneal Epithelial Thickness Across Different Stages of Diabetic Retinopathy Using Anterior Segment OCT.Clinical ophthalmology (Auckland, N.Z.) · 2025Article
91 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We sought to determine whether early nerve damage may be detected by corneal confocal microscopy (CCM), skin biopsy, and neurophysiological tests in 86 recently diagnosed type 2 diabetic patients compared with 48 control subjects. CCM analysis using novel algorithms to reconstruct nerve fiber images was performed for all fibers and major nerve fibers (MNF) only. Intraepidermal nerve fiber density (IENFD) was assessed in skin specimens. Neurophysiological measures included nerve conduction studies (NCS), quantitative sensory testing (QST), and cardiovascular autonomic function tests (AFTs). Compared with control subjects, diabetic patients exhibited significantly reduced corneal nerve fiber length (CNFL-MNF), fiber density (CNFD-MNF), branch density (CNBD-MNF), connecting points (CNCP), IENFD, NCS, QST, and AFTs. CNFD-MNF and IENFD were reduced below the 2.5th percentile in 21% and 14% of the diabetic patients, respectively. However, the vast majority of patients with abnormal CNFD showed concomitantly normal IENFD and vice versa. In conclusion, CCM and skin biopsy both detect nerve fiber loss in recently diagnosed type 2 diabetes, but largely in different patients, suggesting a patchy manifestation pattern of small fiber neuropathy. Concomitant NCS impairment points to an early parallel involvement of small and large fibers, but the precise temporal sequence should be clarified in prospective studies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.