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01-05-2018 | Original Article

Association of glycaemic variability evaluated by continuous glucose monitoring with diabetic peripheral neuropathy in type 2 diabetic patients

Authors: Yu-ming Hu, Li-hua Zhao, Xiu-lin Zhang, Hong-li Cai, Hai-yan Huang, Feng Xu, Tong Chen, Xue-qin Wang, Ai-song Guo, Jian-an Li, Jian-bin Su

Published in: Endocrine | Issue 2/2018

Abstract

Purpose

Diabetic peripheral neuropathy (DPN), a common microvascular complication of diabetes, is linked to glycaemic derangements. Glycaemic variability, as a pattern of glycaemic derangements, is a key risk factor for diabetic complications. We investigated the association of glycaemic variability with DPN in a large-scale sample of type 2 diabetic patients.

Methods

In this cross-sectional study, we enrolled 982 type 2 diabetic patients who were screened for DPN and monitored by a continuous glucose monitoring (CGM) system between February 2011 and January 2017. Multiple glycaemic variability parameters, including the mean amplitude of glycaemic excursions (MAGE), mean of daily differences (MODD), standard deviation of glucose (SD), and 24-h mean glucose (24-h MG), were calculated from glucose profiles obtained from CGM. Other possible risks for DPN were also examined.

Results

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). Using univariate and multiple logistic regression analyses, MAGE and conventional risks including diabetic duration, HOMA-IR, and hemoglobin A1c (HbA1c) 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. 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%.

Conclusions

In addition to conventional risks including diabetic duration, HOMA-IR and HbA1c, increased glycaemic variability assessed by MAGE is a significant independent contributor to DPN in type 2 diabetic patients.

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Title: Association of glycaemic variability evaluated by continuous glucose monitoring with diabetic peripheral neuropathy in type 2 diabetic patients
Authors: Yu-ming Hu
Li-hua Zhao
Xiu-lin Zhang
Hong-li Cai
Hai-yan Huang
Feng Xu
Tong Chen
Xue-qin Wang
Ai-song Guo
Jian-an Li
Jian-bin Su
Publication date: 01-05-2018
Publisher: Springer US
Published in: Endocrine / Issue 2/2018
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-018-1546-z

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