Background: Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of\ndiabetes. Glycemic variability could be an independent risk factor for diabetes complications in addition to average\nglucose. Type 2 diabetes with well-controlled glycosylated hemoglobin A1c (HbA1c) may have different terms of\nglycemic variability and vascular complication consequences. The aim of the study is to investigate the relationship\nbetween glycemic variability and DPN in type 2 diabetes with well-controlled HbA1c (HbA1c < 7.0%).\nMethods: 45 type 2 diabetes with well-controlled HbA1c(HbA1c < 7.0%) and with DPN (DM/DPN group) were\nrecruited in the study, and 45 type 2 diabetes with well-controlled HbA1c and without DPN (DM/ââ?¬â??DPN group) were\nset as controls. The two groups were also matched for age and diabetic duration. Blood pressure, body mass index\n(BMI), insulin sensitivity index (Matsuda index, ISI), total cholesterol (TC), triglyceride (TG), high density lipoprotein\ncholesterol (HDLC), and low density lipoprotein cholesterol (LDLC) were tested in the two groups. And all patients were\nmonitored using the continuous glucose monitoring (CGM) system for consecutive 72 hours. The multiple parameters\nof glycemic variability included the standard deviation of blood glucose (SDBG), mean of daily differences (MODD) and\nmean amplitude of glycemic excursions (MAGE).\nResults: The DM/DPN group had a greater SDBG, MODD and MAGE, when compared to the DM/ââ?¬â??DPN group\n(p < 0.05). BMI, TC, and LDLC of DM/DPN group were lower than those of DM/ââ?¬â??DPN group (p < 0.05). The patients\nwith hypoglycemia were comparable between the two groups (p > 0.05). Univariate analysis showed DPN was closely\nassociated with BMI (OR 0.82, CI 0.72ââ?¬â??0.94, p = 0.005), TC (OR 0.63, CI 0.42ââ?¬â??0.93, p = 0.02), LDLC (OR 0.4, CI 0.20ââ?¬â??0.80,\np = 0.009), SDBG (OR 2.95, CI 1.55ââ?¬â??5.61, p = 0.001), MODD (OR 4.38, CI 1.48ââ?¬â??12.93, p = 0.008), MAGE (OR 2.18,\nCI 1.47ââ?¬â??3.24, p < 0.001). Multivariate logistic regression analysis showed that MAGE (OR 2.05, CI 1.36ââ?¬â??3.09, p = 0.001)\nand BMI (OR 0.85, CI 0.73ââ?¬â??0.99, p = 0.033) were significantly correlating with DPN. Glycemic variability, evaluated by\nMAGE, was the most significantly independent risk factor for DPN.\nConclusions: There was a close relationship between glycemic variability evaluated by MAGE and DPN in type 2\ndiabetes with well-controlled HbA1c.
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