HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 Diabetes
Variability in HbA1c is associated with a higher risk of cardiovascular disease and microvascular complications in patients with type 2 diabetes. The present study evaluated the severity of somatic nerve dysfunction at different stages of chronic glycemic impairment, and its correlation with differe...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2019-02-01
|
| Series: | Frontiers in Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fnins.2019.00090/full |
| _version_ | 1818266396708044800 |
|---|---|
| author | Yun-Ru Lai Yun-Ru Lai Wen-Chan Chiu Chih-Cheng Huang Nai-Wen Tsai Hung-Chen Wang Wei-Che Lin Ben-Chung Cheng Ben-Chung Cheng Yu-Jih Su Chih-Min Su Sheng-Yuan Hsiao Sheng-Yuan Hsiao Cheng-Hsien Lu Cheng-Hsien Lu Cheng-Hsien Lu Cheng-Hsien Lu |
| author_facet | Yun-Ru Lai Yun-Ru Lai Wen-Chan Chiu Chih-Cheng Huang Nai-Wen Tsai Hung-Chen Wang Wei-Che Lin Ben-Chung Cheng Ben-Chung Cheng Yu-Jih Su Chih-Min Su Sheng-Yuan Hsiao Sheng-Yuan Hsiao Cheng-Hsien Lu Cheng-Hsien Lu Cheng-Hsien Lu Cheng-Hsien Lu |
| author_sort | Yun-Ru Lai |
| collection | DOAJ |
| description | Variability in HbA1c is associated with a higher risk of cardiovascular disease and microvascular complications in patients with type 2 diabetes. The present study evaluated the severity of somatic nerve dysfunction at different stages of chronic glycemic impairment, and its correlation with different cardio-metabolic parameters. The study was conducted on 223 patients with type 2 diabetes. We calculated the intrapersonal mean, standard deviation (SD), and coefficient of variation of HbA1c for each patient using all measurements obtained for 3 years prior to the study. Patients were divided into quartiles according to the SD of HbA1c, and we constructed composite scores of nerve conduction as the severity of peripheral neuropathy. Linear regression analysis was performed to evaluate the influence of independent variables on mean composite scores. Those with higher SD-HbA1c had a higher body mass index, mean and index HbA1c, triglyceride and uric acid level, urinary albumin excretion and albumin-creatinine ratio, proportion of insulin therapy, and prevalence of hypertension as the underlying diseases, but lower estimate glomerular filtration rate (eGFR). In addition, those with higher SD-HbA1c showed lower amplitudes and reduced motor nerve conduction velocity in tested nerves, and lower sensory nerve conduction velocity in the sural nerve. Furthermore, those with higher SD-HbA1c had higher composite scores of low extremities. Multiple linear regression analysis revealed that diabetes duration, SD-HbA1c, and eGFR were independently associated with mean composite scores. Based on our results, HbA1c variability plus chronic glycemic impairment is strongly associated with the severity of peripheral neuropathy in patients with type 2 diabetes. Aggressively control blood glucose to an acceptable range and avoid blood glucose fluctuations by individualized treatment to prevent further nerve damage. |
| first_indexed | 2024-12-12T20:06:02Z |
| format | Article |
| id | doaj.art-4a12efa2cff64867b7e2651475105891 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-12-12T20:06:02Z |
| publishDate | 2019-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-4a12efa2cff64867b7e26514751058912022-12-22T00:13:38ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2019-02-011310.3389/fnins.2019.00090427246HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 DiabetesYun-Ru Lai0Yun-Ru Lai1Wen-Chan Chiu2Chih-Cheng Huang3Nai-Wen Tsai4Hung-Chen Wang5Wei-Che Lin6Ben-Chung Cheng7Ben-Chung Cheng8Yu-Jih Su9Chih-Min Su10Sheng-Yuan Hsiao11Sheng-Yuan Hsiao12Cheng-Hsien Lu13Cheng-Hsien Lu14Cheng-Hsien Lu15Cheng-Hsien Lu16Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, TaiwanDepartment of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Biological Science, National Sun Yat-Sen University, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Biological Science, National Sun Yat-Sen University, Kaohsiung, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Biological Science, National Sun Yat-Sen University, Kaohsiung, TaiwanDepartment of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanCenter for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Xiamen Chang Gung Memorial Hospital, Xiamen, ChinaVariability in HbA1c is associated with a higher risk of cardiovascular disease and microvascular complications in patients with type 2 diabetes. The present study evaluated the severity of somatic nerve dysfunction at different stages of chronic glycemic impairment, and its correlation with different cardio-metabolic parameters. The study was conducted on 223 patients with type 2 diabetes. We calculated the intrapersonal mean, standard deviation (SD), and coefficient of variation of HbA1c for each patient using all measurements obtained for 3 years prior to the study. Patients were divided into quartiles according to the SD of HbA1c, and we constructed composite scores of nerve conduction as the severity of peripheral neuropathy. Linear regression analysis was performed to evaluate the influence of independent variables on mean composite scores. Those with higher SD-HbA1c had a higher body mass index, mean and index HbA1c, triglyceride and uric acid level, urinary albumin excretion and albumin-creatinine ratio, proportion of insulin therapy, and prevalence of hypertension as the underlying diseases, but lower estimate glomerular filtration rate (eGFR). In addition, those with higher SD-HbA1c showed lower amplitudes and reduced motor nerve conduction velocity in tested nerves, and lower sensory nerve conduction velocity in the sural nerve. Furthermore, those with higher SD-HbA1c had higher composite scores of low extremities. Multiple linear regression analysis revealed that diabetes duration, SD-HbA1c, and eGFR were independently associated with mean composite scores. Based on our results, HbA1c variability plus chronic glycemic impairment is strongly associated with the severity of peripheral neuropathy in patients with type 2 diabetes. Aggressively control blood glucose to an acceptable range and avoid blood glucose fluctuations by individualized treatment to prevent further nerve damage.https://www.frontiersin.org/article/10.3389/fnins.2019.00090/fullcomposite scores of nerve conductiondiabetic peripheral neuropathyHbA1C variabilitySD-HbA1cType 2 diabetesseverity of peripheral neuropathy |
| spellingShingle | Yun-Ru Lai Yun-Ru Lai Wen-Chan Chiu Chih-Cheng Huang Nai-Wen Tsai Hung-Chen Wang Wei-Che Lin Ben-Chung Cheng Ben-Chung Cheng Yu-Jih Su Chih-Min Su Sheng-Yuan Hsiao Sheng-Yuan Hsiao Cheng-Hsien Lu Cheng-Hsien Lu Cheng-Hsien Lu Cheng-Hsien Lu HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 Diabetes Frontiers in Neuroscience composite scores of nerve conduction diabetic peripheral neuropathy HbA1C variability SD-HbA1c Type 2 diabetes severity of peripheral neuropathy |
| title | HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 Diabetes |
| title_full | HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 Diabetes |
| title_fullStr | HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 Diabetes |
| title_full_unstemmed | HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 Diabetes |
| title_short | HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 Diabetes |
| title_sort | hba1c variability is strongly associated with the severity of peripheral neuropathy in patients with type 2 diabetes |
| topic | composite scores of nerve conduction diabetic peripheral neuropathy HbA1C variability SD-HbA1c Type 2 diabetes severity of peripheral neuropathy |
| url | https://www.frontiersin.org/article/10.3389/fnins.2019.00090/full |
| work_keys_str_mv | AT yunrulai hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT yunrulai hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT wenchanchiu hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT chihchenghuang hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT naiwentsai hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT hungchenwang hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT weichelin hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT benchungcheng hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT benchungcheng hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT yujihsu hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT chihminsu hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT shengyuanhsiao hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT shengyuanhsiao hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT chenghsienlu hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT chenghsienlu hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT chenghsienlu hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes AT chenghsienlu hba1cvariabilityisstronglyassociatedwiththeseverityofperipheralneuropathyinpatientswithtype2diabetes |