Assessment of Diabetic Polyneuropathy in Inpatient Care: Fasting Blood Glucose, HbA1c, Electroneuromyography and Diabetes Risk Factors

Suljić, Enra; Kulasin, Igor; Alibegovic, Vanja

doi:10.5455/aim.2013.21.123-126

Cited by 10 publications

(9 citation statements)

References 9 publications

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“…Maximum patients (56.8%) have a DM duration for >10 years. HbA1c and longer duration of DM are strongly related with development of DPN which have been documented in a number of previous studies 9, [14][15][16][17] which demonstrates the similar pattern of HbA 1c mean value and disease duration in patients of DPN. Maximum patients (56%) of the study population have HbA1c≥ 7%.…”

Section: Clinical Severitysupporting

confidence: 70%

Glycemic Control and Clinico-Electrophysiological Severity of Diabetic Polyneuropathy

Joy¹,

Hasan

Islam

et al. 2019

J. Natl Inst. Neurosci Bangladesh

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Background: Diabetic polyneuropathy (DPN) has a significant positive correlation with poor glycemic control (HbA1c ≥7%). The clinical, biochemical and electrophysiological parameters of DPN in Bangladeshi citizens have not yet been explored elaborately Objective: The purpose of the study was to detect and categorize status of glycemic control of Bangladeshi people and to analyze its impact on clinical severity of DPN using Toronto Clinical Scoring System (TCSS) and electrophysiological severity by modified Michigan diabetic neuropathy score (MDNS). Methodology: This observational study was carried out on diabetic patients having probable DPN by purposive sampling, attending Neurology OPD of Dhaka Medical College Hospital, Dhaka, Bangladesh and Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine & Metabolic Disorder (BIRDEM) Hospital, Dhaka, Bangladesh from July 2014 to June 2016. Clinical parameters were recorded and DPN was graded as “no neuropathy”, “mild”, “moderate” and “severe” neuropathy by the Toronto Clinical Scoring System (TCSS). A standard nerve conduction study was performed on each patient and electrophysiological grading according to modified Michigan diabetic neuropathy score (MDNS) was done. Diabetic status of patients was classified into “controlled” (HbA1c <7.0%) and “uncontrolled” (HbA1c ≥7.0%) groups and HbA1c level and the clinical & electrophysiological severity scores were compared and were analyzed. Results: Mean age of the patients was 57.2±9.37 years. 51.0% cases were males and 49% cases were females. The mean HbA1c in the study population was 7.6±0.94% and 56.0% patients had HbA1c≥ 7% .Motor nerve conduction studies revealed that both CMAP amplitudes and MNCV in the ulnar, peroneal and tibial nerves were reduced significantly in patients of uncontrolled (HbA1c≥7%) DM (p<0.001). Sensory nerve conduction studies revealed significant reduction in SNAP amplitudes of median and ulnar sensory and sural nerves in the uncontrolled group (p<0.001). Electrophysiologically, 65.43% patients had mixed sensory-motor neuropathy (p<0.00001). Clinically severe DPN patients were higher (45.2%) within the uncontrolled (HbA1C ≥7%) group (p<0.00001). Similarly, severity in electrophysiological grading was more in patients with uncontrolled DM (48.8%) (p<0.00001). Conclusions: Neuropathic severity, either clinically or electrophysiologically, was associated with higher values of HbA1c. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 177-184

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Section: Clinical Severitysupporting

confidence: 70%

Glycemic Control and Clinico-Electrophysiological Severity of Diabetic Polyneuropathy

Joy¹,

Hasan

Islam

et al. 2019

J. Natl Inst. Neurosci Bangladesh

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“…These results were consistent with findings of other studies. 21,30,31 It was to be found that the peripheral neuropathy was more common in females than males which was also observed by Alam 32 but contrast to other studies. 21,22,24,33 This study also revealed a significant association of peripheral neuropathy with non-urban(rural and semi urban) residence.…”

Section: Hba 1c Categories (%)contrasting

confidence: 51%

Evaluation of Different HbA1c Levels to Assess the Risk of Peripheral Neuropathy Among Type 2 Diabetic Patients Along With Other Conventional Risk Factors

Hoque¹,

Muttalib

Islam³

et al. 2017

Bangladesh Med Res Counc Bull

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This cross sectional study was carried out in the outpatient department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Bangladesh (BIRDEM) General Hospital, Dhaka, to explore the factors influencing or related to the development of the diabetic peripheral neuropathy (DPN) with specific concern to the HbA1c levels. A total of 400 patients with type 2 diabetic were selected to collect information on sociodemographic, blood pressure, anthropometry and lipid profile. Glycaemic status was assessed by HbA1c and plasma glucose levels. Prevalence of DPN was 16.8%, with male 10.8% and female 20.9%. Increased HbA1c categories above 7.0% were significantly associated with increased prevalence of DPN (9.2 Vs. 10.5 Vs 26.5%; χ 2 = 19.446, p = .000). Logistic regression models showed that the risk of DPN was strongly increased at the HbA1c categories ≥8% (OR = 3.57; 95% CI: 1.75-7.26). Advanced age (OR = 1.97; 95% CI: 1.12-3.47), longer duration of diabetes (OR = 1.81; 95% CI: 1.02-3.19), lacking of physical exercise (OR = 2.60; 95% CI: 1.47-4.58), female gender (OR = 2.17; 95% CI: 1.21-3.89), fasting blood glucose (OR = 1.153; 95% CI: 1.058-1.255) and blood glucose 2 hours after breakfast (OR = 1.096; 95% CI: 1.029-1.168) were significant risk factors of DPN. However, there is need of a large scale community based prospective study to validate the results.

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“…This finding agrees to others 7,[16][17][18][19][20] . But Ashok et al found lower FSG and HbA1c 21 .…”

Section: Discussionsupporting

confidence: 83%

Glycaemic status and insulin resistance in diabetic peripheral neuropathy

Akter

Akhter

Rahman

et al. 2016

J Bangladesh Soc Physiol

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Background: Complication of diabetes mellitus includes peripheral neuropathy which causes ischemic foot ulceration. Hyperglycemia and insulin resistance may accelerate the development of diabetic peripheral neuropathy. Objective: To assess the glycaemic status and insulin resistance for development of peripheral neuropathy in type 2 diabetes mellitus. Methods: This control case control study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2014 to June 2015. A total number of 150 Type 2 diabetic patients of both sexes were selected with age ranging 40 to 50 years. Among them, 75 patients with peripheral neuropathy were included in study group and 75 patients without peripheral neuropathy were control. For evaluation of glycaemic status, fasting serum glucose (FSG), Glycosylated hemoglobin (HbA1c) and to calculate insulin resistance by homeostatic model assessment for insulin resistance (HOMA-IR), fasting serum insulin (FSI), were estimated. For statistical analysis, unpaired Student's 't' test was done. Results: In this study, significant increase in FSG, HbA1c, FSI, HOMA-IR were found in diabetic subjects with peripheral neuropathy in comparison to control group. Conclusion: From the study results, it is concluded that poor glycaemic control and greater insulin resistance may be associated with diabetic peripheral neuropathy.

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Assessment of Diabetic Polyneuropathy in Inpatient Care: Fasting Blood Glucose, HbA1c, Electroneuromyography and Diabetes Risk Factors

Cited by 10 publications

References 9 publications

Glycemic Control and Clinico-Electrophysiological Severity of Diabetic Polyneuropathy

Glycemic Control and Clinico-Electrophysiological Severity of Diabetic Polyneuropathy

Evaluation of Different HbA1c Levels to Assess the Risk of Peripheral Neuropathy Among Type 2 Diabetic Patients Along With Other Conventional Risk Factors

Glycaemic status and insulin resistance in diabetic peripheral neuropathy

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