| Objective(s):This study attempted to continuously monitor the blood glucose and sudomotor function(SF)in patients with type 2 diabetes mellitus(T2DM),and explore the relationship between the change rhythm of SF,the severity of SF and the level and fluctuation of blood glucose.Methods:Our study will collect 206 patients with T2 DM and 34 healthy people from the Department of Endocrinology and Metabolism of Yunnan First People’s Hospital from2021 to 2022.The sudomotor function was detected continuously for 14 times every hour in healthy people and continuously for 7 times every hour in T2 DM patients during continuous dynamic glucose monitoring(CGM).The general clinical data,blood biochemical data and sudomotic function values of T2 DM patients were collected,including mean electrochemical conductivity(HESC)of both hands and mean electrochemical conductivity(FESC)of both feet.Grouping:Health group;HESC/FESC>60μS were in the normal sweating group.The group with both HESC/FESC>60μS and≤60μS was classified as the reversible sweating function group.HESC/FESC≤60μS were consistent abnormal sweating function group.The latter two groups were abnormal sweating function group.Spearman linear correlation analysis,multiple stepwise linear regression analysis and general linear model(GLM)were used to analyze the correlation.Binary logistic regression was used to analyze the independent risk factors.Results:1.Analysis of the rhythm of sweating function in healthy people: Single factor repeated measurement analysis showed that there was no statistical significance in the value difference of daytime sweating function detection at each time point(P>0.05),suggesting that sweating function had no time rhythm in healthy people;2.Comparison of general conditions: Compared with the normal sudomotor function group,the abnormal sudomotor function group was older [(57.27 ± 1.074)vs(52.47±1.356)years old,t=2.719,P<0.05] and had longer diabetes duration[(11.55±0.79)vs(4.91±0.49)years,t=-7.332,P<0.01],higher blood urea nitrogen level [(6.848±0.783)vs(5.238±0.133),t=-2.161,P<0.05],higher creatinine level[(70.21±3.313)vs(64.44±1.434),t=-1.671,P<0.01],bone mineral density was also more likely to show decreased bone mineral density or osteoporosis(P<0.05),vibration perception threshold(VPT)examination in the abnormal hand test was higher [(9.123±0.309)vs(7.491±0.213),t=-4.439,P<0.05],and the difference was statistically significant(P<0.05).P<0.05],and the positive rate of abnormal fundus screening was higher(P<0.05);3.Comparison of blood glucose fluctuation parameters:Blood glucose variability was higher in the group with persistently abnormal sudomotor function than in the normal group(P<0.05),followed by the reversible sweating function group(P<0.05);4.Comparison of fluctuation amplitude of sweating function: The maximum fluctuation range of perspirant function among healthy subjects,normal perspirant function group,reversible perspirant function group,and continuously abnormal perspirant function group was compared in pairs.The maximum fluctuation range in HESC and FESC of reversible perspirant function group was about 26μS(P<0.05),and that of normal perspirant function group was less than 16μS;5.Risk factor analysis of sudomotor function: the results showed that age,course of disease,high BMI,smoking,systolic blood pressure,diastolic blood pressure,fasting blood glucose,urea nitrogen,creatinine,visceral fat area were independent risk factors for sudomotor dysfunction;6.Correlation analysis between sudomotor function and blood glucose and central tendency analysis: The results of 7 tests of sweating function and 7 tests of blood glucose at corresponding time points were analyzed by the general linear model(GLM),and it was found that there was no correlation between the changes of the two indexes in the group with normal sweating function and the group with sustained abnormal sweating function at the corresponding time(P>0.05).In the reversible sweating function group,the detection of sweating function in HESC and FESC was affected by blood glucose fluctuation in the corresponding time change(P<0.05).Since the detection of sweating function in the reversible sweating function group was related to blood glucose,the central tendency analysis of sweating function and blood glucose in this group showed that when HESC and FESC were both higher than 60μs,blood glucose was mostly distributed in the range of 5-10mmol/L.Conclusions:1.During the day,there was no time rhythm in sweating function,no detection peak or low peak,and no difference in detection results at any time in a day;2.Age,duration of diabetes,BMI,smoking,SDP,DBP,FBG,BUN,Cr and visceral fat area are independent risk factors for sudomotor dysfunction,and HDL-C is a protective factor for sudomotor dysfunction;3.The higher the blood glucose variability,the more severe the peripheral nerve damage;The detection of sweating function in the normal sweating function group and the continuously abnormal sweating function group was not affected by the change of blood glucose.The changes of blood glucose in the reversible sweating function group are easy to cause changes in related indexes of sweating function.Under good blood glucose control,peripheral nerve function can be recovered,and the blood glucose in this group is mostly distributed between 5-10mmol/L,and the fluctuation range of sweating function in this group is larger than that in other groups. |
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