A new study finds that incipient peripheral neuropathy in patients with type 1 diabetes can be predicted by a technique called corneal confocal microscopy (CCM).
What is corneal confocal microscopy?
CCM is a clinical technique that studies the structure and nerve fibres of the cornea, using a laser-scanning corneal confocal microscope.
CCM has previously been used to assess peripheral diabetic neuropathy and neuropathy in those with prediabetes.
In a study conducted by Queensland University of Technology, Australia, 90 type 1 diabetic patients without neuropathy were found to have 63 per cent sensitivity and 74 per cent specificity for detecting diabetic peripheral neuropathy over a four-year period.
101 patients aged 14-80 had previously enrolled, all without peripheral neuropathy. Of the 90 who were assessed after four years, 16 per cent had developed diabetic peripheral neuropathy.
Study co-author Dr Rayaz A Malik, Weill Cornell Medical College, New York and Qatar told Medscape Medical News: “This is a hugely important study, as it shows for the first time that CCM can be used to predict those who will develop diabetic peripheral neuropathy.
“In an ideal world, we would see this as a screening tool much like diabetic retinal screening for retinopathy and microalbuminuria for incipient nephropathy. This is based on data showing that CCM abnormality is present very early and occurs even in patients without retinopathy or microalbuminuria,” added Dr Malik.
However, researchers point out that this reality is not likely to occur anytime soon as the imaging tools and software are not widely possessed by medical units.

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