Diabetic Peripheral Neuropathy and Glycemia Risk Index in Type 2 Diabetes: A Cross-Sectional Study

Overview

Journal Diabetes Metab Syndr Obes

Publisher Dove Medical Press

Specialty Endocrinology

Date 2024 Nov 11

PMID 39526203

Authors

Yuchen Tang

Pingping Zhang

Li Li

Jialin Li

Affiliations

Soon will be listed here.

Abstract

Purpose: Diabetic peripheral neuropathy (DPN) is a prevalent chronic complication of diabetes which is linked to chronic hyperglycemia and glycemic variability. This study aimed to investigate the association between the glycemia risk index (GRI) and DPN in patients with type 2 diabetes mellitus (T2DM) using continuous glucose monitoring (CGM) data.

Patients And Methods: From 2019 to 2023, 862 adults diagnosed with T2DM were enrolled at a tertiary care diabetes center in Ningbo, China. The medical history and laboratory parameters were recorded. Neurophysiological examinations were performed to evaluate DPN. The CGM data were recorded for 14 days, and the GRI was calculated based on these data. Multivariate logistic regression analyses were conducted to assess the odds ratio (OR) for DPN with an increased GRI.

Results: The prevalence of DPN in the ascending GRI quartiles was 41.6%, 47.9%, 49.1%, and 59.5%, respectively ( for trend < 0.001). In the multivariable logistic analysis, the highest GRI quartile exhibited a 63% greater risk of DPN (OR 1.631, 95% CI: 1.071 to 2.484, = 0.023) than the lowest quartile after adjusted for age, sex, body mass index, diabetes duration, blood pressure, creatinine, urinary albumin-to-creatinine ratio, lipid profile and glycated hemoglobin.

Conclusion: High GRI levels, as measured by CGM, were associated with a greater likelihood of DPN in T2DM patients.

Citing Articles

Implications of the Glycemia Risk Index in Assessing Metabolic Control and its Correlation With Therapy-Related Quality of Life During-Ramadan Fasting in Adults With Type 2 Diabetes.

Al Hayek A, Al Zahrani W, Al Dawish M J Diabetes Sci Technol. 2025; :19322968251321860.

PMID: 40022432 PMC: 11871576. DOI: 10.1177/19322968251321860.

References

Pan X, Wang L, Pan A . Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol. 2021; 9(6):373-392. DOI: 10.1016/S2213-8587(21)00045-0. View

Cai L, Shen W, Li J, Wang B, Sun Y, Chen Y . Association between glycemia risk index and arterial stiffness in type 2 diabetes. J Diabetes Investig. 2024; 15(5):614-622. PMC: 11060162. DOI: 10.1111/jdi.14153. View

Papachristoforou E, Lambadiari V, Maratou E, Makrilakis K . Association of Glycemic Indices (Hyperglycemia, Glucose Variability, and Hypoglycemia) with Oxidative Stress and Diabetic Complications. J Diabetes Res. 2020; 2020:7489795. PMC: 7585656. DOI: 10.1155/2020/7489795. View

Pop-Busui R, Boulton A, Feldman E, Bril V, Freeman R, Malik R . Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2016; 40(1):136-154. PMC: 6977405. DOI: 10.2337/dc16-2042. View

Yang J, Yang X, Zhao D, Wang X, Wei W, Yuan H . Association of time in range, as assessed by continuous glucose monitoring, with painful diabetic polyneuropathy. J Diabetes Investig. 2020; 12(5):828-836. PMC: 8089011. DOI: 10.1111/jdi.13394. View

Yoo J, Kim J, Kim J . Association Between Continuous Glucose Monitoring-Derived Glycemia Risk Index and Albuminuria in Type 2 Diabetes. Diabetes Technol Ther. 2023; 25(10):726-735. DOI: 10.1089/dia.2023.0165. View

Pai Y, Lin C, Lee I, Chang M . Hypoglycaemic episodes and risk of diabetic peripheral neuropathy in patients with type 2 diabetes. Diabetes Metab. 2017; 45(4):395-398. DOI: 10.1016/j.diabet.2017.09.009. View

Ma L, Chen J, Sun Y, Feng Y, Yuan L, Ran X . The perceptions of living with diabetic foot ulcers: A systematic review and meta-synthesis of qualitative studies. J Tissue Viability. 2022; 32(1):39-50. DOI: 10.1016/j.jtv.2022.11.005. View

Elafros M, Andersen H, Bennett D, Savelieff M, Viswanathan V, Callaghan B . Towards prevention of diabetic peripheral neuropathy: clinical presentation, pathogenesis, and new treatments. Lancet Neurol. 2022; 21(10):922-936. PMC: 10112836. DOI: 10.1016/S1474-4422(22)00188-0. View

10.

Seaquist E, Miller M, Bonds D, Feinglos M, Goff Jr D, Peterson K . The impact of frequent and unrecognized hypoglycemia on mortality in the ACCORD study. Diabetes Care. 2011; 35(2):409-14. PMC: 3263892. DOI: 10.2337/dc11-0996. View

11.

Ceriello A, Monnier L, Owens D . Glycaemic variability in diabetes: clinical and therapeutic implications. Lancet Diabetes Endocrinol. 2018; 7(3):221-230. DOI: 10.1016/S2213-8587(18)30136-0. View

12.

Wright R, Newby D, Stirling D, Ludlam C, Macdonald I, Frier B . Effects of acute insulin-induced hypoglycemia on indices of inflammation: putative mechanism for aggravating vascular disease in diabetes. Diabetes Care. 2010; 33(7):1591-7. PMC: 2890364. DOI: 10.2337/dc10-0013. View

13.

Pai Y, Tang C, Lin C, Lin S, Lee I, Chang M . Glycaemic control for painful diabetic peripheral neuropathy is more than fasting plasma glucose and glycated haemoglobin. Diabetes Metab. 2020; 47(1):101158. DOI: 10.1016/j.diabet.2020.04.004. View

14.

Quagliaro L, Piconi L, Assaloni R, Martinelli L, Motz E, Ceriello A . Intermittent high glucose enhances apoptosis related to oxidative stress in human umbilical vein endothelial cells: the role of protein kinase C and NAD(P)H-oxidase activation. Diabetes. 2003; 52(11):2795-804. DOI: 10.2337/diabetes.52.11.2795. View

15.

An Y, Liu S, Wang W, Dong H, Zhao W, Ke J . Low serum levels of bone turnover markers are associated with the presence and severity of diabetic retinopathy in patients with type 2 diabetes mellitus. J Diabetes. 2020; 13(2):111-123. DOI: 10.1111/1753-0407.13089. View

16.

Brownlee M . Biochemistry and molecular cell biology of diabetic complications. Nature. 2001; 414(6865):813-20. DOI: 10.1038/414813a. View

17.

Eslami S, Taherzadeh Z, Schultz M, Abu-Hanna A . Glucose variability measures and their effect on mortality: a systematic review. Intensive Care Med. 2011; 37(4):583-93. PMC: 3058514. DOI: 10.1007/s00134-010-2129-5. View

18.

Lee C, Lui D, Cheung C, Fong C, Yuen M, Woo Y . Circulating AFABP, FGF21, and PEDF Levels as Prognostic Biomarkers of Sight-threatening Diabetic Retinopathy. J Clin Endocrinol Metab. 2023; 108(9):e799-e806. DOI: 10.1210/clinem/dgad112. View

19.

Wang Y, Lu J, Ni J, Wang M, Shen Y, Lu W . Association between glycaemia risk index (GRI) and diabetic retinopathy in type 2 diabetes: A cohort study. Diabetes Obes Metab. 2023; 25(9):2457-2463. DOI: 10.1111/dom.15068. View

20.

Gouveri E, Papanas N . The Emerging Role of Continuous Glucose Monitoring in the Management of Diabetic Peripheral Neuropathy: A Narrative Review. Diabetes Ther. 2022; 13(5):931-952. PMC: 9076783. DOI: 10.1007/s13300-022-01257-5. View