Correlation Between TIR And Peripheral Neuropathy In Patients With Type 2 Diabetes

Objective: Diabetic peripheral neuropathy(DPN)is one of the most common chronic complications of diabetes mellitus.The onset of DPN is insidious.Early diagnosis and timely intervention can significantly improve the prognosis.Good blood glucose control is the cornerstone of delaying the development of chronic complications of diabetes.At present,there are many methods to evaluate blood glucose control,such as glycosylated hemoglobin,dynamic blood glucose monitoring,and so on.Each method has different advantages and disadvantages.Flashing glucose monitoring technology provides a new blood glucose monitoring method for diabetic patients,which has certain advantages in the evaluation of immediate blood glucose and blood glucose fluctuation,and TIR is the basis to evaluate blood glucose and diabetic complications.However,there are few studies on the relationship between time in range(TIR)and diabetic complications.In this study,we discuss the correlation between TIR and DPN,in order to provide a new idea to prevent the occurrence of DPN and delay its process.Methods: From October 2019 to January 2020,60 patients with type 2 diabetes mellitus(T2DM)were enrolled in the Department of endocrinology of Hebei General hospital.They were divided into two groups according to whether the nerve conduction velocity was normal or not.We recorded their baseline data and collected the test indicators such as homocysteine,blood lipid,TIR collected by the flashing blood glucose meter.To explore the relationship among TIR,Hcy,HDL-C and type 2 diabetic peripheral neuropathy.Result:1.Comparison of basic clinical data between the DPN and the NDPN groupsOf the 60 patients with type 2 diabetes,41 were in the DPN group and 19 in the NDPN group.The prevalence of DPN was 68.3%.BMI was higher than that in the NDPN group.Hcy,Hb A1 c and Hcy/HDL levels in the DPN group were higher than those in the NDPN group,while TIR and HDL-C levels were lower than those in the NDPN group(P< 0.05).In this study,glycosylated hemoglobin,fasting blood glucose,triglyceride,total cholesterol,and other indicators were also compared,but the difference was not statistically significant(P >0.05).2.Analysis of influencing factors of DPNLogistic regression analysis showed that Hb A1 c,Hcy and Hcy /HDL-C were the risk factors of DPN,and TIR and HDL-C were the protective factors of DPN(P < 0.05).3.Correlation analysis of different Hcy,Hb A1 c levels,and incidence of DPNHcy was divided into high Hcy group and normal Hcy group.The incidence of DPN was 100% and 35.7% respectively.Taking Hb A1 c 6.0% as the boundary,it was divided into Q1 group: Hb A1 c ? 6.0%,Q2 group: Hb A1c>6.0%,DPN incidence was 39%,79% respectively.Point two correlation between Hb A1 c and DPN showed that there was a positive correlation between Hb A1 c and DPN,and the correlation coefficient was 0.471,which was statistically significant(P < 0.001).4.Sensitivity and specificity of TIR and other indicators in predicting the occurrence of DPNThe ROC curve was used to analyze the prediction results of TIR,Hcy,Hcy/HDL-C,HDL-C and Hb A1 c on diabetic peripheral neuropathy.The results showed that the five variables had statistical significance(P < 0.05)on the prediction results of diabetic peripheral neuropathy.Combined with the area under the curve,the prediction results were good.Conclusion:1.The level of TIR in the DPN group was lower than that in the NDPN group,indicating that the better blood glucose control,the lower the incidence of DPN.2.The level of HDL-C in DPN group was lower than that in the NDPN group,the difference was statistically significant,which suggested that increasing the HDL-C level was helpful to reduce the incidence of DPN.3.The level of Hb A1 c in the DPN group was higher than that in the NDPN group,the difference was statistically significant,indicating that poor blood glucose control can promote the occurrence of DPN.4.The Hcy level of the DPN group was higher than that of the NDPN group,indicating that high homocysteine level can increase the incidence rate of DPN.More research is needed on whether vitamin B12 and folic acid supplementation could delay the progress of DPN.5.TIR and HDL-C are protective factors of DPN,Hb A1 c,Hcy and Hcy /HDL-C are risk factors of DPN.6.ROC curve analysis results show that TIR,Hcy,Hcy/HDL-C,Hb A1 c,HDL-C have good prediction effect on the occurrence of DPN.