Glycemic Variability's Impact on Painful Diabetic Peripheral Neuropathy in Type 2 Diabetes Patients

Overview

Journal Sci Rep

Specialty Science

Date 2024 Sep 27

PMID 39333368

Authors

Kuo-Cheng Chang

Yen-Wei Pai

Ching-Heng Lin

I-Te Lee

Ming-Hong Chang

Affiliations

Soon will be listed here.

Abstract

Hyperglycemia in type 2 diabetes leads to diabetic peripheral neuropathy (DPN) and neuropathic pain, yet the association between glycemic variability and painful DPN remains insufficiently evidenced. To address this, we conducted a prospective longitudinal cohort study involving adult type 2 diabetes patients at a medical center. DPN was identified using the Michigan Neuropathy Screening Instrument (MNSI), and neuropathic pain was assessed with the Taiwan version of the Douleur Neuropathique 4 (DN4-T) questionnaire. At baseline in 2013, all participants were free of DPN and were re-evaluated in 2019 for the development of painful DPN. We measured visit-to-visit glycemic fluctuations using the coefficient of variation (CV) of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c). Patients were stratified into tertiles according to their FPG-CV and HbA1c-CV. Among the 622 participants, 267 developed DPN during the six-year follow-up. Following matching of age and sex, 210 patients without DPN and 210 with DPN (including 26 with neuropathic pain) were identified. Our findings revealed a significant association between high FPG-CV and painful DPN, with the highest tertile showing an adjusted odds ratio of 2.82 (95% confidence interval 1.04-7.64) compared to the lowest tertile. On the contrary, HbA1c-CV did not show a significant association with the risk of painful DPN. Our study indicates that higher FPG-CV is associated with an increased risk of painful DPN, supporting the role of glycemic variability in the development of painful DPN.

Citing Articles

A correlation study between blood glucose fluctuation and chronic pain in the older people with type 2 diabetes mellitus.

Huang Q, Cui M, Yin Y, Hui C, Cheng Y, Wang S BMC Geriatr. 2024; 24(1):1028.

PMID: 39709342 PMC: 11662845. DOI: 10.1186/s12877-024-05616-8.

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