Relationship between continuous glucose monitoring and corneal neuropathy in type 2 diabetes
Authors' conclusion
CGM measures, including mean glycemia, TIR, TITR, and glucose variability, were significantly associated with corneal neuropathy, supporting the role of CGM metrics in optimizing glycemia.
Study context
- Population
- People with T2D wearing a 14-day blinded Freestyle Libre Pro continuous glucose monitoring (CGM) and undergoing corneal in vivo confocal microscopy; median age 58 years, 49.5% female, 60.6% Chinese, body mass index (BMI) 26.6 kg/m², diabetes duration 12 years, HbA1c 8.1%277 analysed
- Participants
- 307 people
- Outcome
- Associations of HbA1c and CGM metrics with corneal nerve fiber and cellular metrics (GEE, adjusted)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- HbA1c vs corneal nerve fiber density (negative)
- β −0.609, pseudoR² = 0.068, P = .013
- HbA1c vs corneal nerve fiber width (CNFW) (positive)
- β .003, pseudoR² = 0.066, P = .027
- Time-in-range (TIR) and time-in-tight-range (TITR) vs CNFW (negative)
- both β −.006; pseudoR² = 0.075 and 0.066, respectively; both P < .03
- Time-above-range (TAR) vs CNFW (positive)
- β .006, pseudoR² = 0.073, P = .021
- TAR vs average epithelial size (positive)
- β .088, pseudoR² = 0.055, P = .004
- Mean glucose vs average epithelial size (positive)
- β .049, pseudoR² = 0.055, P = .004
- Glucose variability (SD, MAGE, mean of daily differences) vs average epithelial size (positive)
- β .13, 0.046, and .164; pseudoR²= 0.053, 0.044, and 0.060, respectively, all P < .03
- TIR and TITR vs average epithelial size (negative)
- β −.084 and −.104; pseudoR² = 0.052 and 0.057, respectively, both P < .01
Observational data: associations, not effects.
Original publication
Relationship between continuous glucose monitoring and corneal neuropathy in type 2 diabetes. J Clin Endocrinol Metab. Published 28 January 2026. doi:10.
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