Hormones (Athens, Greece)Sep 11, 2026

Improvement in small nerve damage seen in the eye after semaglutide treatment: a case report and review

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Sep 12, 2026

Abstract

A 57-year-old man with type 2 diabetes and obesity exhibited unchanged neuropathy symptom scores after 6 months of semaglutide treatment, despite improvement in metabolic parameters.

The patient presented with diabetic peripheral neuropathy, indicated by a neuropathy symptom score of 3/9 and a neuropathy disability score of 3/10.
Vibration perception threshold was measured at 22 volts bilaterally, indicating small fiber involvement.
Semaglutide treatment led to improvements in body mass index and glycemic control, with an HbA1c of 6.6%.
Corneal confocal microscopy showed improvements in corneal nerve parameters after 6 months of treatment.
Results suggest that semaglutide may have an effect on small nerve fiber regeneration in diabetic peripheral neuropathy.

Simplified

Diabetic peripheral neuropathy (DPN) is the most common chronic complication of type 2 diabetes (T2D) and a major predisposing factor for the development of diabetic foot, one of the most devastating diabetes-related conditions associated with substantial morbidity and mortality. To date, no pharmacological therapy has been shown capable of preventing, halting, or reversing neuropathic damage. We report the case of a 57-year-old man with T2D and obesity (BMI 35.2 kg/m²) who presented with symptoms and signs of DPN, including a neuropathy symptom score (NSS) of 3/9, a neuropathy disability score (NDS) of 3/10, and a vibration perception threshold (VPT) of 22 volts (V) bilaterally. In vivo corneal confocal microscopy (CCM) was performed to further evaluate small fiber involvement. Despite adequate glycemic control (HbA_1c 6.6%), semaglutide was initiated to optimize metabolic status and promote weight loss. After 6 months of treatment, both BMI and HbA_1c had improved, while NSS, NDS, and VPT remained unchanged. Repeat CCM demonstrated improvement across all corneal nerve parameters. This case suggests that semaglutide-associated metabolic improvement, or a direct semaglutide effect on small fiber integrity, may contribute to early regeneration of small nerve fibers in DPN. Further studies are urgently needed to determine whether semaglutide has a therapeutic role in the management of DPN.

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Improvement in small nerve damage seen in the eye after semaglutide treatment: a case report and review

Abstract

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