{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T03:00:51Z","timestamp":1760151651227,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Juvenile Diabetes Research Foundation","award":["8-2008-362"],"award-info":[{"award-number":["8-2008-362"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>There is a need to accurately identify patients with diabetes at higher risk of developing and progressing diabetic peripheral neuropathy (DPN). Fifty subjects with Type 1 Diabetes Mellitus (T1DM) and sixteen age matched healthy controls underwent detailed neuropathy assessments including symptoms, signs, quantitative sensory testing (QST), nerve conduction studies (NCS), intra epidermal nerve fiber density (IENFD) and corneal confocal microscopy (CCM) at baseline and after 2 years of follow-up. Overall, people with type 1 diabetes mellitus showed no significant change in HbA1c, blood pressure, lipids or neuropathic symptoms, signs, QST, neurophysiology, IENFD and CCM over 2 years. However, a sub-group (n = 11, 22%) referred to as progressors, demonstrated rapid corneal nerve fiber loss (RCNFL) with a reduction in corneal nerve fiber density (CNFD) (p = 0.0006), branch density (CNBD) (p = 0.0002), fiber length (CNFL) (p = 0.0002) and sural (p = 0.04) and peroneal (p = 0.05) nerve conduction velocities, which was not related to a change in HbA1c or cardiovascular risk factors. The majority of people with T1DM and good risk factor control do not show worsening of neuropathy over 2 years. However, CCM identifies a sub-group of people with T1DM who show a more rapid decline in corneal nerve fibers and nerve conduction velocity.<\/jats:p>","DOI":"10.3390\/jcm11082249","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T22:04:02Z","timestamp":1650319442000},"page":"2249","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Corneal Confocal Microscopy Identifies People with Type 1 Diabetes with More Rapid Corneal Nerve Fibre Loss and Progression of Neuropathy"],"prefix":"10.3390","volume":"11","author":[{"given":"Uazman","family":"Alam","sequence":"first","affiliation":[{"name":"Division of Diabetes, Endocrinology and Gastroenterology, Institute of Human Development, University of Manchester, Manchester M13 9PL, UK"},{"name":"Department of Cardiovascular & Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-1248","authenticated-orcid":false,"given":"Georgios","family":"Ponirakis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Weill Cornell Medicine-Qatar, Doha 24144, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Asghar","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Gastroenterology, Institute of Human Development, University of Manchester, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis N.","family":"Petropoulos","sequence":"additional","affiliation":[{"name":"Department of Medicine, Weill Cornell Medicine-Qatar, Doha 24144, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shazli","family":"Azmi","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Gastroenterology, Institute of Human Development, University of Manchester, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3492-0177","authenticated-orcid":false,"given":"Maria","family":"Jeziorska","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University of Manchester, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Marshall","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Gastroenterology, Institute of Human Development, University of Manchester, Manchester M13 9PL, UK"},{"name":"Department of Clinical Neurophysiology, Central Manchester NHS Foundation Trust, Manchester M13 9WL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J. M.","family":"Boulton","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Gastroenterology, Institute of Human Development, University of Manchester, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7037-779X","authenticated-orcid":false,"given":"Nathan","family":"Efron","sequence":"additional","affiliation":[{"name":"Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane City, QLD 4000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7188-8903","authenticated-orcid":false,"given":"Rayaz A.","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Medicine, Weill Cornell Medicine-Qatar, Doha 24144, Qatar"},{"name":"Institute of Cardiovascular Science, University of Manchester, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/j.clinthera.2018.04.001","article-title":"Diabetic Peripheral Neuropathy: Epidemiology, Diagnosis, and Pharmacotherapy","volume":"40","author":"Iqbal","year":"2018","journal-title":"Clin. 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