Evidence map›Paper›PMID 40053106›Full record

ArticleDiabetologia2025

Metformin therapy modifies corneal neuroimmune abnormalities in people with type 2 diabetes.

Amy T Tsoi, Janice Sng, Shyam S Tummanapalli, Tushar Issar, Ann M Poynten, Kerry-Lee Milner, Maria Markoulli, Roshan Dhanapalaratnam, Arun V Krishnan

Abstract read
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In one paragraph

Article in Diabetologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Repair of Corneal Epithelial Defects.Progress in molecular and subcellular biology · 2026
    Review
  3. Review
  4. Causal Central Network Remodeling in Diabetic Neuropathy: An Integrated MR-fMRI Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Amy T TsoiSchool of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
Janice SngSchool of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
Shyam S TummanapalliSchool of Optometry & Vision Science, University of New South Wales, Sydney, NSW, Australia.
Tushar IssarSchool of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
Ann M PoyntenSchool of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
Kerry-Lee MilnerSchool of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
Maria MarkoulliSchool of Optometry & Vision Science, University of New South Wales, Sydney, NSW, Australia.
Roshan DhanapalaratnamSchool of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
Arun V KrishnanSchool of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia. arun.krishnan@unsw.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisDiabetic peripheral neuropathy is a debilitating microvascular complication of diabetes mellitus, with limited disease-modifying therapies to date. This study aimed to assess the effect of metformin on the corneal sub-basal nerve plexus as a peripheral neuropathy outcome measure in people with type 2 diabetes.

methodsA cohort of 36 participants with type 2 diabetes receiving metformin therapy were recruited and underwent clinical assessment, corneal confocal microscopy and nerve conduction studies. Concurrently, 36 participants with type 2 diabetes not receiving metformin therapy were selected as disease controls and matched to participants on metformin therapy for age, sex, diabetes duration, BMI, eGFR, HbA

resultsParticipants receiving metformin therapy had higher corneal nerve fibre density (p=0.020), corneal nerve fibre length (p=0.020) and corneal fractal dimension (p=0.003) compared with those not receiving metformin therapy. The inferior whorl dendritic cell density was significantly lower in the metformin group compared with the non-metformin group (p=0.043). CONCLUSIONS/

interpretationMetformin treatment is associated with superior corneal nerve parameters and neuroimmune tone in the corneal sub-basal nerve plexus. This study provides further evidence that metformin may be neuroprotective in diabetic peripheral neuropathy.

Indexed as

CorneaDiabetes Mellitus, Type 2Diabetic NeuropathiesHypoglycemic AgentsMetforminAgedFemaleHumansMaleMiddle AgedNerve FibersNeural ConductionHypoglycemic AgentsMetforminCorneal nerve injuryDiabetic peripheral neuropathyIn vivo corneal confocal microscopyMetformin

Identifiers

PMID40053106
PMCPMC12069440

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY
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Registered trials

None linked

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.