Glycemic profile variability: An independent risk factor for diabetic neuropathy in patients with type 2 diabetes. Issue 1 (February 2023)

• Record Type: Journal Article
• Authors: Firouzabadi, Mohammad Dehghani; Poopak, Amirhossein; Sheikhy, Ali; Samimi, Sahar; Nakhaei, Pooria; Firouzabadi, Fatmeh Dehghani; Moosaie, Fatemeh; Rabizadeh, Soghra; Nakhjavani, Manouchehr; Esteghamati, Alireza
• Is Part Of: Primary care diabetes. Volume 17:Issue 1(2023)
• Page Start: 38
• Page End: 42
• Publication Date: 2023-02
• Subjects: Glycemic profile variability -- HbA1c -- 2hpp -- FBS -- Diabetes type 2 -- Diabetic neuropathy; Diabetes -- Periodicals; 616.462
• DOI: 10.1016/j.pcd.2022.11.011
• Languages: English
• ISSNs: 1751-9918

Abstract

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. 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.