Corneal Confocal Microscopy Predicts Cardiovascular and Cerebrovascular Events and Demonstrates Greater Peripheral Neuropathy in Patients with Type 1 Diabetes and Foot Ulcers

• DOI: 10.3390/diagnostics13172793
• Publication Date: 2023-08-29T12:35:05Z
• Authors: Jonathan Z. M. Lim; Jamie Burgess; Cheong Ooi; Maryam Ferdousi; Shazli Azmi; Alise Kalteniece; Matthew Anson; Daniel J. Cuthber...; Ioannis N. Petrop...; Rayaz A. Malik; John P. H. Wilding; Uazman Alam
• Keywords: Medicine (General); R5-920; cardiovascular disease; diabetic peripheral neuropathy; corneal confocal microscopy; diabetic foot ulcer; complications of diabetes; type 1 diabetes mellitus; Article

In this study, we evaluate small and large nerve fibre pathology in relation to diabetic foot ulceration (DFU) incident cardiovascular cerebrovascular events type 1 diabetes (T1D).A prospective observational study was conducted on people with T1D without peripheral neuropathy (DPN) (n = 25), DPN 28), DFU 25) 32 healthy volunteers. ROC analysis of parameters diagnose DFU, multivariate Cox regression performed the predictive ability corneal nerves for cardiac over 3 years.Corneal length (CNFL), density (CNFD) branch (CNBD) were lower T1D-DPN T1D-DFU vs. (all p < 0.001). analysis, CNFD (sensitivity 88%, specificity 87%; AUC 0.93; 0.001; optimal cut-off 7.35 no/mm2) CNFL 76%, 77%; 0.90; 7.01 mm/mm2) had good differentiate DFU. Incident (p 0.001) significantly higher T1D-DFU. Corneal loss, specifically predicted (HR 1.67, 95% CI 1.12 2.50, 0.01) 1.55, 1.06 2.26, 0.02) events.Our provides threshold values metrics neuropathic at risk further demonstrates that predicts T1D.