Highlights
- •FBS, 2hPP, HbA1c variability are significantly higher in DPN-developed diabetic patients.
- •CV- FBS, CV-FBS 10 % and 20 %, CV-2hpp 20 % and 5 %, and CV-HbA1c 10 % as potential risk factors for DPN development.
- •Patients who developed DPN had significantly higher variabilities of FBS.
Abstract
Background
Impaired glycemic control is a potential predictor for macro- and microvascular complications
of diabetes, which could be recognized by glycemic variability. The aim of this 10-year
prospective cohort study presented here is to gain a better understanding of the correlation
between GV and diabetic peripheral neuropathy (DPN) as one of the most common complications
of T2DM.
Methods
Since February 2010, 1152 adult patients with T2DM have been followed-up. Baseline
features, anthropometric measurements, and laboratory findings were collected and
documented during ten years. The association between DPN incidence and glycemic profile
variability was evaluated using cox regression analysis. The coefficient of variation
of glycemic indices within subjects was calculated and compared using an independent
sample t-test.
Results
Individuals who developed neuropathy had significantly higher mean levels of glycemic
indices (HbA1c, FBS, and 2hpp), urinary albumin excretion, mean creatinine levels,
and a longer duration of diabetes. A significant positive correlation between incidence
of DPN and glycemic profile variability (cv-FBS10 %, cv-FBS20 %, cv-2hpp20 %, cv-HbA1c5 %
and cv-HbA1c10 %) was revealed. Results also showed that higher variability of FBS
was associated with the higher risk of neuropathy incidence (HR: 12.29, p-value: 0.045),
which indicates that glycemic profile variability is an independent risk factor for
DPN in patients with T2DM.
Conclusion
Variability of glycemic profiles from a visit to visit, regardless of sustained hyperglycemia,
was indeed a significant risk factor for DPN in diabetic type 2 patients. CV-FBS was
the most critical glycemic variability indices for DPN development.
Keywords
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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 26,
2022
Received in revised form:
November 23,
2022
Received:
May 14,
2022
Identification
Copyright
© 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
