2020/04/16 by Tushar Issar, T. Issar, S. S. Tummanapalli +13 · 1 citation
Medicine · #Ocular Surface and Contact Lens #Pain Mechanisms and Treatments #Retinal Diseases and Treatments
paper · doi:10.1111/dme.14306
openalex publication_date 2020/04/16 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
Abstract Aim To examine the associations between continuous overlapping net glycaemic action (CONGA), percentage time in hyperglycaemia (%HG) or normoglycaemia (%NG) and peripheral nerve structure and function in type 1 diabetes. Methods Twenty‐seven participants with type 1 diabetes underwent continuous glucose monitoring followed by corneal confocal microscopy and nerve excitability assessments. CONGA, %HG (> 10.0 mmol/l) and %NG (3.9–10.0 mmol/l) were correlated against corneal nerve fibre length and density in the central cornea and inferior whorl region, corneal microneuromas, and a nerve excitability score while controlling for age, sex, diabetes duration and HbA 1c . Results An increase in CONGA [median 2.5 (2.0–3.1) mmol/l] or %HG (mean 46 ± 18%) was associated with a worse nerve excitability score ( r = –0.433, P = 0.036 and r = –0.670, P = 0.0012, respectively). By contrast, greater %NG (51 ± 17%) correlated with better nerve excitability scores ( r = 0.672, P = 0.0011). Logistic regression revealed that increasing %HG increased the likelihood of abnormal nerve function [odds ratio (OR) 1.11, 95% confidence interval (CI) 1.01–1.23; P = 0.037). An increase in CONGA and %HG were associated with worsening nerve conduction measures, whereas longer %NG correlated with improved nerve conduction variables. CONGA and %HG were associated with inferior whorl corneal nerve fibre length ( r = 0.483, P = 0.034 and r = 0.591, P = 0.021, respectively) and number of microneuromas ( r = 0.433, P = 0.047 and r = 0.516, P = 0.020, respectively). Conclusions Short‐term measures of glucose control are associated with impaired nerve function and alterations in corneal nerve morphology.