Differential impact of short-term and long-term glycemic variability on peripheral nerve function in type 2 diabetes: A 5-year cohort study

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2025-05-16 DOI:10.1016/j.jdiacomp.2025.109081

Takamasa Iwamoto , Machiko Morita , Shuji Hidaka , Kentaro Sada , Miyuki Iwamoto , Hirotaka Shibata

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引用次数: 0

Abstract

Aims

Several studies have demonstrated the association between glycemic variability (GV) and diabetic peripheral neuropathy (DPN). However, none has compared the effects of short-term and long-term GV on DPN in a cohort. This study evaluates the association between short-term and long-term GV and peripheral nerve function in a cohort of outpatients with type 2 diabetes.

Methods

Overall, 230 patients who had continuously attended the outpatient hospital for 5 years were enrolled. Short-term GV was assessed using continuous glucose monitoring (FreeStyle Libre Pro®), focusing on metrics such as the glucose levels’' standard deviation and time in range. Long-term GV was evaluated by using visit-to-visit variability in glycated hemoglobin (HbA1c), including the HbA1c standard deviation and coefficient of variation. Nerve conduction was assessed using DPNCheck™ by measuring sural nerve action potential (SNAP) amplitude and sensory conduction velocity (SCV). Multiple regression models were built to determine independent associations of GV and HbA1c variability metrics with SCV and SNAP amplitude.

Results

Most short-term GV indices were not associated with SNAP amplitude but significantly correlated with SCV; these associations were not evident after adjusting for HbA1c. Long-term GV showed minimal correlation with SCV, while strong associations with SNAP amplitude persisted after adjusting for the 5-year mean HbA1c.

Conclusions

Our findings demonstrate that short-term and long-term GVs have differential impacts on peripheral nerve function in outpatients with type 2 diabetes; with short-term GV associated with SCV and long-term with SNAP amplitude.

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短期和长期血糖变异性对2型糖尿病周围神经功能的不同影响：一项5年队列研究

几项研究已经证实了血糖变异性（GV）与糖尿病周围神经病变（DPN）之间的关联。然而，在一个队列中，没有人比较短期和长期GV对DPN的影响。本研究评估了一组2型糖尿病门诊患者的短期和长期GV与周围神经功能之间的关系。方法共纳入230例门诊连续就诊5年的患者。使用连续血糖监测（FreeStyle Libre Pro®）评估短期GV，重点关注血糖水平“标准差”和范围内时间等指标。通过糖化血红蛋白（HbA1c）的每次访问变异性来评估长期GV，包括HbA1c标准差和变异系数。通过测量腓肠神经动作电位（SNAP）振幅和感觉传导速度（SCV），采用DPNCheck™评估神经传导。建立多元回归模型以确定GV和HbA1c变异性指标与SCV和SNAP振幅的独立关联。结果大部分短期GV指数与SNAP振幅无关，但与SCV显著相关；在调整HbA1c后，这些关联不明显。长期GV与SCV的相关性很小，而在调整5年平均HbA1c后，与SNAP振幅的相关性仍然很强。结论短期和长期GVs对2型糖尿病门诊患者周围神经功能的影响存在差异；短期GV与SCV相关，长期GV与SNAP振幅相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.