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Updated: Jun 17, 2026

Corneal Confocal Microscopy: A Novel Non-invasive Technique to Quantify Small Fibre Pathology in Peripheral Neuropathies
Published on: January 3, 2011
Altered C-fiber function as an indicator of early peripheral neuropathy in individuals with impaired glucose
Alistair Q Green1, Singhan Krishnan, Francis M Finucane
1The Diabetes Research Centre, Ipswich Hospital National Health Service Trust, Suffolk, UK.
Objective:
This study explored the importance of glycemic burden compared with features of the metabolic syndrome in the pathogenesis of diabetic neuropathy by comparing C-fiber function in people with type 1 diabetes to that in people with impaired glucose tolerance (IGT).
Research Design And Methods:
The axon reflex-elicited flare areas (LDIflares) were measured with a laser Doppler imager (LDI) in age-, height-, and BMI-matched groups with IGT (n = 14) and type 1 diabetes (n = 16) and in healthy control subjects (n = 16).
Results:
The flare area was reduced in the IGT group compared with the control (2.78 +/- 1.1 vs. 5.23 +/- 1.7 cm(2), P = 0.0001) and type 1 diabetic (5.16 +/- 2.3 cm(2), P = 0.002) groups, whereas the flare area was similar in the type 1 diabetic and control groups.
Conclusions:
This technique suggests that small-fiber neuropathy is a feature of IGT. The absence of similar small-fiber neuropathy in those with longstanding type 1 diabetes suggests that glycemia may not be the major determinant of small-fiber neuropathy in IGT.
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