{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:10:37Z","timestamp":1789139437119,"version":"build-2803163510"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005187","name":"University of Athens","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005187","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hormones"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Diabetic peripheral neuropathy (DPN) is the most common chronic complication of type 2 diabetes (T2D) and a major predisposing factor for the development of diabetic foot, one of the most devastating diabetes-related conditions associated with substantial morbidity and mortality. To date, no pharmacological therapy has been shown capable of preventing, halting, or reversing neuropathic damage. We report the case of a 57-year-old man with T2D and obesity (BMI 35.2\u00a0kg\/m\u00b2) who presented with symptoms and signs of DPN, including a neuropathy symptom score (NSS) of 3\/9, a neuropathy disability score (NDS) of 3\/10, and a vibration perception threshold (VPT) of 22 volts (V) bilaterally. In vivo corneal confocal microscopy (CCM) was performed to further evaluate small fiber involvement. Despite adequate glycemic control (HbA\n                    <jats:sub>1c<\/jats:sub>\n                    6.6%), semaglutide was initiated to optimize metabolic status and promote weight loss. After 6 months of treatment, both BMI and HbA\n                    <jats:sub>1c<\/jats:sub>\n                    had improved, while NSS, NDS, and VPT remained unchanged. Repeat CCM demonstrated improvement across all corneal nerve parameters. This case suggests that semaglutide-associated metabolic improvement, or a direct semaglutide effect on small fiber integrity, may contribute to early regeneration of small nerve fibers in DPN. Further studies are urgently needed to determine whether semaglutide has a therapeutic role in the management of DPN.\n                  <\/jats:p>","DOI":"10.1007\/s42000-026-00826-8","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:25:31Z","timestamp":1789136731000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improvement of small fiber neuropathy assessed by corneal confocal microscopy following semaglutide treatment: a case report and literature review"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7560-0575","authenticated-orcid":false,"given":"Ioanna A.","family":"Anastasiou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Tentolouris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Rebelos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"issue":"17","key":"826_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21176275","volume":"21","author":"U Galicia-Garcia","year":"2020","unstructured":"Galicia-Garcia U, Benito-Vicente A, Jebari S et al (2020) Pathophysiology of type 2 diabetes mellitus. Int J Mol Sci 21(17):6275. https:\/\/doi.org\/10.3390\/ijms21176275","journal-title":"Int J Mol Sci"},{"key":"826_CR2","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/b978-0-444-53480-4.00016-3","volume":"126","author":"RA Malik","year":"2014","unstructured":"Malik RA (2014) Pathology of human diabetic neuropathy. Handb Clin Neurol 126:249\u2013259. https:\/\/doi.org\/10.1016\/b978-0-444-53480-4.00016-3","journal-title":"Handb Clin Neurol"},{"issue":"6","key":"826_CR3","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.2337\/dc14-2422","volume":"38","author":"X Chen","year":"2015","unstructured":"Chen X, Graham J, Dabbah MA et al (2015) Small Nerve Fiber Quantification in the Diagnosis of Diabetic Sensorimotor Polyneuropathy: Comparing Corneal Confocal Microscopy With Intraepidermal Nerve Fiber Density. Diabetes Care 38(6):1138\u20131144. https:\/\/doi.org\/10.2337\/dc14-2422","journal-title":"Diabetes Care"},{"key":"826_CR4","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103363","volume":"86","author":"A Moiz","year":"2025","unstructured":"Moiz A, Filion KB, Tsoukas MA et al (2025) The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions. eClinicalMedicine 86. https:\/\/doi.org\/10.1016\/j.eclinm.2025.103363","journal-title":"eClinicalMedicine"},{"issue":"4","key":"826_CR5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2026.109290","volume":"40","author":"M Ziori","year":"2026","unstructured":"Ziori M, Tentolouris A, Eleftheriadou I et al (2026) Corneal confocal microscopy and cardiac autonomic neuropathy in individuals with type 1 diabetes mellitus. J Diabetes Complicat 40(4):109290. https:\/\/doi.org\/10.1016\/j.jdiacomp.2026.109290","journal-title":"J Diabetes Complicat"},{"issue":"5","key":"826_CR6","doi-asserted-by":"publisher","first-page":"838","DOI":"10.2337\/dc14-2311","volume":"38","author":"M Tavakoli","year":"2015","unstructured":"Tavakoli M, Ferdousi M, Petropoulos IN et al (2015) Normative values for corneal nerve morphology assessed using corneal confocal microscopy: a multinational normative data set. Diabetes Care 38(5):838\u2013843. https:\/\/doi.org\/10.2337\/dc14-2311","journal-title":"Diabetes Care"},{"issue":"8","key":"826_CR7","doi-asserted-by":"publisher","first-page":"1478","DOI":"10.1007\/s00125-019-4897-y","volume":"62","author":"S Azmi","year":"2019","unstructured":"Azmi S, Jeziorska M, Ferdousi M et al (2019) Early nerve fibre regeneration in individuals with type 1 diabetes after simultaneous pancreas and kidney transplantation. Diabetologia 62(8):1478\u20131487. https:\/\/doi.org\/10.1007\/s00125-019-4897-y","journal-title":"Diabetologia"},{"issue":"1\u20132","key":"826_CR8","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/0006-8993(93)91496-f","volume":"607","author":"P Fernyhough","year":"1993","unstructured":"Fernyhough P, Willars GB, Lindsay RM et al (1993) Insulin and insulin-like growth factor I enhance regeneration in cultured adult rat sensory neurones. Brain Res 607(1\u20132):117\u2013124. https:\/\/doi.org\/10.1016\/0006-8993(93)91496-f","journal-title":"Brain Res"},{"issue":"1","key":"826_CR9","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2020-001420","volume":"8","author":"G Ponirakis","year":"2020","unstructured":"Ponirakis G, Abdul-Ghani MA, Jayyousi A et al (2020) Effect of treatment with exenatide and pioglitazone or basal-bolus insulin on diabetic neuropathy: a substudy of the Qatar study. BMJ Open Diabetes Res Care 8(1):e001420. https:\/\/doi.org\/10.1136\/bmjdrc-2020-001420","journal-title":"BMJ Open Diabetes Res Care"},{"issue":"12","key":"826_CR10","doi-asserted-by":"publisher","first-page":"7982","DOI":"10.1167\/iovs.14-15605","volume":"55","author":"C Dehghani","year":"2014","unstructured":"Dehghani C, Pritchard N, Edwards K et al (2014) Natural history of corneal nerve morphology in mild neuropathy associated with type 1 diabetes: development of a potential measure of diabetic peripheral neuropathy. Invest Ophthalmol Vis Sci 55(12):7982\u20137990. https:\/\/doi.org\/10.1167\/iovs.14-15605","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"3","key":"826_CR11","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.61.3.48","volume":"61","author":"M Ferdousi","year":"2020","unstructured":"Ferdousi M, Kalteniece A, Petropoulos I et al (2020) Diabetic neuropathy is characterized by progressive corneal nerve fiber loss in the central and inferior whorl regions. Invest Ophthalmol Vis Sci 61(3):48. https:\/\/doi.org\/10.1167\/iovs.61.3.48","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"5","key":"826_CR12","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.2337\/dc17-2062","volume":"41","author":"ST Andersen","year":"2018","unstructured":"Andersen ST, Witte DR, Dalsgaard EM et al (2018) Risk Factors for Incident Diabetic Polyneuropathy in a Cohort With Screen-Detected Type 2 Diabetes Followed for 13 Years: ADDITION-Denmark. Diabetes Care 41(5):1068\u20131075. https:\/\/doi.org\/10.2337\/dc17-2062","journal-title":"Diabetes Care"},{"issue":"4","key":"826_CR13","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1111\/jns.12664","volume":"29","author":"G Ponirakis","year":"2024","unstructured":"Ponirakis G, Al-Janahi I, Elgassim E et al (2024) Glucose-lowering medication associated with weight loss may limit the progression of diabetic neuropathy in type 2 diabetes. J Peripher Nerv Syst 29(4):406\u2013414. https:\/\/doi.org\/10.1111\/jns.12664","journal-title":"J Peripher Nerv Syst"}],"container-title":["Hormones"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s42000-026-00826-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s42000-026-00826-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s42000-026-00826-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:25:33Z","timestamp":1789136733000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s42000-026-00826-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":13,"alternative-id":["826"],"URL":"https:\/\/doi.org\/10.1007\/s42000-026-00826-8","relation":{},"ISSN":["1109-3099","2520-8721"],"issn-type":[{"value":"1109-3099","type":"print"},{"value":"2520-8721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"assertion":[{"value":"12 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"None","order":1,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}