Association Of Glycaemic Variability Evaluated By Continuous Glucose Monitoring With Diabetic Peripheral Neuropathy In Type 2 Diabetic Patients

PurposeDiabetic peripheral neuropathy(DPN),one of a common microvascular complication of diabetes,is linked to glycaemic derangements.glycaemic variability,as a pattern of glycaemic derangements,could be a significant risk factor for diabetic complications in addition to long-term chronic hyperglycaemia.large clinical studies have indicated that risk factors besides long-term chronic hyperglycaemia and glycaemic variability are involved in chronic macrocomplications/microcomplications of diabetes.We compared the associations of glycaemic variability and traditional risk factors with DPN among a large-scale sample of type 2 diabetic patients.Methods1.In this cross-sectional study,we enrolled 982 type 2 diabetic patients between February 2011 and January 2017.2.All patients were performed DPN assessments,such as neurological symptoms and electromyography.3.Glycaemic variabilities were assessed by MAGE、MODD、SD and 24-h MG,respectively.4.HbAlc was also determined upon enrolment to assess current overall glycaemic control.Other risk factors were examined such as age,sex,Body mass index and blood pressure.Results1、Of the recruited type 2 diabetic patients,20.1%(n = 197)presented with DPN,and these patients also had a higher MAGE,MODD,SD,and 24-h MG than patients without DPN(p<0.001).2、Using univariate and multiple logistic regression analyses,MAGE and conventional risks including diabetic duration,HOMA-IR,and hemoglobin Alc(HbAlc)were found to be independent contributors to DPN,and the corresponding odds ratios(95%confidence interval)were 4.57(3.48-6.01),1.10(1.03-1.17),1.24(1.09-1.41),and 1.33(1.15-1.53),respectively.3、Receiver operating characteristic analysis indicated that the optimal MAGE cutoff value for predicting DPN was 4.60 mmol/L;the corresponding sensitivity was 64.47%,and the specificity was 75.54%.ConclusionsIn addition to conventional risks including diabetic duration,HOMA-IR and HbAlc,increased glycaemic variability assessed by MAGE is a significant independent contributor to DPN in type 2 diabetic patients.