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. 2014 Dec 15;6(1):139.
doi: 10.1186/1758-5996-6-139. eCollection 2014.

The relationship between glycemic variability and diabetic peripheral neuropathy in type 2 diabetes with well-controlled HbA1c

Feng Xu  1 , Li-Hua Zhao  1 , Jian-Bin Su  1 , Tong Chen  2 , Xue-Qin Wang  1 , Jin-Feng Chen  1 , Gang Wu  1 , Yan Jin  1 , Xiao-Hua Wang  1
Affiliations

The relationship between glycemic variability and diabetic peripheral neuropathy in type 2 diabetes with well-controlled HbA1c

Feng Xu et al. Diabetol Metab Syndr. .

Abstract

Background: Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of diabetes. Glycemic variability could be an independent risk factor for diabetes complications in addition to average glucose. Type 2 diabetes with well-controlled glycosylated hemoglobin A1c (HbA1c) may have different terms of glycemic variability and vascular complication consequences. The aim of the study is to investigate the relationship between glycemic variability and DPN in type 2 diabetes with well-controlled HbA1c (HbA1c < 7.0%).

Methods: 45 type 2 diabetes with well-controlled HbA1c(HbA1c < 7.0%) and with DPN (DM/DPN group) were recruited in the study, and 45 type 2 diabetes with well-controlled HbA1c and without DPN (DM/-DPN group) were set as controls. The two groups were also matched for age and diabetic duration. Blood pressure, body mass index(BMI), insulin sensitivity index (Matsuda index, ISI), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), and low density lipoprotein cholesterol (LDLC) were tested in the two groups. And all patients were monitored using the continuous glucose monitoring (CGM) system for consecutive 72 hours. The multiple parameters of glycemic variability included the standard deviation of blood glucose (SDBG), mean of daily differences (MODD) and mean amplitude of glycemic excursions (MAGE).

Results: The DM/DPN group had a greater SDBG, MODD and MAGE, when compared to the DM/-DPN group (p < 0.05). BMI, TC, and LDLC of DM/DPN group were lower than those of DM/-DPN group (p < 0.05). The patients with hypoglycemia were comparable between the two groups (p > 0.05). Univariate analysis showed DPN was closely associated with BMI (OR 0.82, CI 0.72-0.94, p = 0.005), TC (OR 0.63, CI 0.42-0.93, p = 0.02), LDLC (OR 0.4, CI 0.20-0.80, p = 0.009), SDBG (OR 2.95, CI 1.55-5.61, p = 0.001), MODD (OR 4.38, CI 1.48-12.93, p = 0.008), MAGE (OR 2.18, CI 1.47-3.24, p < 0.001). Multivariate logistic regression analysis showed that MAGE (OR 2.05, CI 1.36-3.09, p = 0.001) and BMI (OR 0.85, CI 0.73-0.99, p = 0.033) were significantly correlating with DPN. Glycemic variability, evaluated by MAGE, was the most significantly independent risk factor for DPN.

Conclusions: There was a close relationship between glycemic variability evaluated by MAGE and DPN in type 2 diabetes with well-controlled HbA1c.

Keywords: Continuous glucose monitoring; Diabetic peripheral neuropathy; Glycemic variability; Type 2 diabetes.

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References

    1. Carrington AL, Shaw JE, Van Schie CH, Abbott CA, Vileikyte L, Boulton AJ. Can motor nerve conduction velocity predict foot problems in diabetic subjects over a 6-year outcome period? Diabetes Care. 2002;25:2010–2015. doi: 10.2337/diacare.25.11.2010. - DOI - PubMed
    1. Boulton AJ, Malik RA, Arezzo JC, Sosenko JM. Diabetic somatic neuropathies. Diabetes Care. 2004;27:1458–1486. doi: 10.2337/diacare.27.6.1458. - DOI - PubMed
    1. Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, Malik RA, Maser RE, Sosenko JM, Ziegler D, American Diabetes Association Diabetic neuropathies: a statement by the american diabetes association. Diabetes Care. 2005;28:956–962. doi: 10.2337/diacare.28.4.956. - DOI - PubMed
    1. Tesfaye S, Vileikyte L, Rayman G, Sindrup S, Perkins B, Baconja M, Vinik A, Boulton A, on behalf of the Toronto Expert Panel on Diabetic Neuropathy Painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev. 2011;27:629–638. doi: 10.1002/dmrr.1225. - DOI - PubMed
    1. Candrilli SD, Davis KL, Kan HJ, Lucero MA, Rousculp MD. Prevalence and the associated burden of illness of symptoms of diabetic peripheral neuropathy and diabetic retinopathy. J Diabetes Complicat. 2007;21:306–314. doi: 10.1016/j.jdiacomp.2006.08.002. - DOI - PubMed

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