The risk of third, fourth, and sixth cranial nerve palsies rises sharply with worsening glycemic status, according to a nationwide South Korean study of more than 4 million adults. 

Over a 6.3-year follow-up, 5,835 adults developed cranial nerve palsy. Compared with individuals with normal glucose levels, those with impaired fasting glucose had a 10% higher risk (aHR 1.09), while newly diagnosed diabetes increased risk by 78% (aHR 1.77). The risk nearly doubled in patients with diabetes for less than five years (HR 1.92) and was more than 2.5 times higher in those with diabetes for five years or longer (HR 2.57). 

The findings emphasize the need for tight glucose control and early neuro-ophthalmic monitoring in patients with diabetes.