Effect of Glycemic Variability on Peripheral Neuropathy in Patients with Type-2 Diabetes
DOI:
https://doi.org/10.36283/PJMD13-3/023Keywords:
Diabetes Mellitus type II, Diabetic neuropathies, Body Mass Index.Abstract
About 75% of diabetic neuropathies are distal symmetrical sensorimotor polyneuropathy (DSPN), among the most frequent preventable causes of limb amputation. This study examined the connection between type-2 diabetics with well-controlled HbA1C and DSPN about glycemic variability. This cross-sectional study through convenient sampling recruited a total of 42 patients with 21 type-2 diabetics with well-controlled HbA1c (<7%) and without DSPN as control and 21 patients with DSPN at Liaquat National Hospital, December 2022 and June 2023. Both groups were tested for blood pressure, body mass index, total cholesterol, and high-density lipoprotein. Through the mean of daily differences, we calculated the glycemic variability. DM/DSPN group had more significant glycemic variability 203+/-38.18 v/s 110.84+/-28.25 compared to DM/-DSPN group. When compared to control, DSPN patients with well-controlled HbA1c displayed higher glycemic variability. The most important independent risk factor for DSPN was glucose fluctuation. Using SPSS v.19, the Chi-square along with the student t-test was employed with p<0.05 was significant.
Keywords: Diabetes Mellitus type-2, Diabetic neuropathies, Body Mass Index.
References
Christensen MMB, Hommel EE, Jørgensen ME, Fleischer J, Hansen CS. Glycemic Variability and Diabetic Neuropathy in Young Adults With Type 1 Diabetes. Front Endocrinol (Lausanne). 2020;11:644. doi: 10.3389/fendo.2020.00644.
Tesfaye S, Boulton AJ, Dyck PJ, Freeman R, Horowitz M, Kempler P, Lauria G, Malik RA, Spallone V, Vinik A, Bernardi L, Valensi P; Toronto Diabetic Neuropathy Expert Group. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010;33(10):2285-2293. doi: 10.2337/dc10-1303.
Martin CL, Albers JW, Pop-Busui R; DCCT/EDIC Research Group. Neuropathy and related findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Diabetes Care. 2014;37(1):31-38. doi: 10.2337/dc13-2114.
Ali A, Iqbal F, Taj A, Iqbal Z, Amin MJ, Iqbal QZ. Prevalence of microvascular complications in newly diagnosed patients with type 2 diabetes. Pak J Med Sci. 2013;29(4):899-902. doi: 10.12669/pjms.294.3704.
Lakhiar M A, Shahbaz N, Bughio A H, PrakashJ. Frequency of peripheral neuropathy in newly diagnosed patients of diabetes mellitus on clinical and electrophysiological basis.Pak J Neurol Sci (PJNS): 2014; 9:31-35.
Takao T, Ide T, Yanagisawa H, Kikuchi M, Kawazu S, Matsuyama Y. The effect of fasting plasma glucose variability on the risk of retinopathy in type 2 diabetic patients: retrospective long-term follow-up. Diabetes Res Clin Pract. 2010;89(3):296-302. doi: 10.1016/j.diabres.2010.03.027.
Kwai NC, Arnold R, Poynten AM, Krishnan AV. Association between glycemic variability and peripheral nerve dysfunction in type 1 diabetes. Muscle Nerve. 2016;54(5):967-969. doi: 10.1002/mus.25274.
Virk SA, Donaghue KC, Cho YH, Benitez-Aguirre P, Hing S, Pryke A, Chan A, Craig ME. Association Between HbA1c Variability and Risk of Microvascular Complications in Adolescents With Type 1 Diabetes. J Clin Endocrinol Metab. 2016;101(9):3257-3263. doi: 10.1210/jc.2015-3604.
Lachin JM, Bebu I, Bergenstal RM, Pop-Busui R, Service FJ, Zinman B, Nathan DM, DCCT/EDIC Research Group. Association of glycemic variability in type 1 diabetes with progression of microvascular outcomes in the diabetes control and complications trial. Diabetes care. 2017;40(6):777-783. doi: 10.2337/dc16-2426.
Akaza M, Akaza I, Kanouchi T, Sasano T, Sumi Y, Yokota T. Nerve conduction study of the association between glycemic variability and diabetes neuropathy. Diabetology & metabolic syndrome. 2018;10:69. doi: 10.1186/s13098-018-0371-0.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Medicine and Dentistry
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access article distributed under the terms of the CreativeCommons Attribution License (CC BY) 4.0 https://creativecommons.org/licenses/by/4.0/