Evidence mapPaperPMID 42315492Full record

ArticleDiabetes, obesity & metabolism2026

Diabetic Corneal Neuropathy as a Window Into Diabetic Foot Risk: A Large-Scale Association Study.

Chang Liu, Mingyi Yu, Isabelle Xin Yu Lee, Gavin Patrick O'Donnell, Hong Chang Tan, Aya Takahashi-Nakajima, Yixin Wang, Mui Hui Koh, Ho Sean Matthew Chung-Hei, Hasika Wickrama Senevirathne and 3 more

Abstract read
In one paragraph

Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Chang LiuRegenerative Therapy Group, Singapore Eye Research Institute, Singapore, Singapore.
Mingyi YuRegenerative Therapy Group, Singapore Eye Research Institute, Singapore, Singapore.
Isabelle Xin Yu LeeRegenerative Therapy Group, Singapore Eye Research Institute, Singapore, Singapore.
Gavin Patrick O'DonnellDepartment of Podiatry, Singapore General Hospital, Singapore, Singapore.
Hong Chang TanDepartment of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Aya Takahashi-NakajimaRegenerative Therapy Group, Singapore Eye Research Institute, Singapore, Singapore.
Yixin WangRegenerative Therapy Group, Singapore Eye Research Institute, Singapore, Singapore.
Mui Hui KohDepartment of Podiatry, Singapore General Hospital, Singapore, Singapore.
Ho Sean Matthew Chung-HeiRegenerative Therapy Group, Singapore Eye Research Institute, Singapore, Singapore.
Hasika Wickrama SenevirathneData Science Unit, Singapore Eye Research Institute, Singapore, Singapore.ORCID https://orcid.org/0000-0001-8937-5148
Hla Myint HtoonData Science Unit, Singapore Eye Research Institute, Singapore, Singapore.
Ching-Yu ChengOphthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
Yu-Chi LiuRegenerative Therapy Group, Singapore Eye Research Institute, Singapore, Singapore.ORCID https://orcid.org/0000-0001-5408-0382

Funding

National Medical Research Council CSIRG24jul-0010National Medical Research Council MOH-CSAINV24jul-0005
6 · The paper itself

Abstract

aimsTo evaluate the association between diabetic corneal neuropathy and diabetic foot risk by examining corneal nerve features, clinical characteristics, and tear mediators in patients with different diabetic foot risk categories.

methodsIn this cross-sectional study, 710 participants underwent diabetic foot examination, in vivo confocal microscopy scans, ocular surface assessments, and tear mediators measurements. Ordinal regression analysis was applied to determine the associations between foot risk categories and corneal nerve metrics. ROC curve analysis assessed the ability of corneal nerve parameters to identify high-risk diabetic foot.

resultsAll diabetic foot risk categories exhibited significantly impaired corneal nerve fibre length, density, fractal dimension, and more swollen width compared with controls (all p < 0.001). These patients also demonstrated significantly shorter tear break-up time, more severe ocular symptoms, elevated tear MMP-9, and reduced tear Substance P levels (all p < 0.05). Patients with high-risk diabetic foot showed significantly more pronounced corneal nerve alterations than those in low and moderate-risk groups (all p < 0.05). The more severe diabetic foot risk category was significantly associated with reduced nerve fibre length, density, fractal dimension, and increased width (all p < 0.05). A predictive model incorporating corneal nerve fibre length, width, and serum creatinine achieved an AUC of 0.80 for identifying high-risk diabetic foot. A CNFL < 5.7 mm/mm

conclusionCorneal nerve impairment is evident even in low-risk diabetic foot patients and is associated with foot risk severity. Corneal nerve metrics may serve as early indicators for identifying high-risk diabetic foot.

Indexed as

CorneaCorneal DiseasesDiabetic FootDiabetic NeuropathiesAgedCross-Sectional StudiesDiabetes Mellitus, Type 2FemaleHumansMaleMicroscopy, ConfocalMiddle AgedNerve FibersRisk FactorsTearscorneal nervesdiabetic corneal neuropathydiabetic foot riskocular surfacetear mediators

Identifiers

PMID42315492
PMCPMC13448846

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.