healthmedicinet

Research

Feng Xu, Li-hua Zhao, Jian-bin Su, Tong Chen, Xue-qin Wang, Jin-feng Chen, Gang Wu, Yan Jin and Xiao-hua Wang

Abstract (provisional)

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.