Association of glycaemic variability evaluated by continuous glucose monitoring with diabetic peripheral neuropathy in type 2 diabetic patients
Abstract
Purpose Diabetic peripheral neuropathy (DPN), a common microvascular complication of diabetes, is linked to glycaemic derangements. Glycaemic variability, as a pattern of glycaemic derangements, is a key risk factor for diabetic complications. We investigated the association of glycaemic variability with DPN in a large-scale sample of type 2 diabetic patients.Methods In this cross-sectional study, we enrolled 982 type 2 diabetic patients who were screened for DPN and monitored by a continuous glucose monitoring (CGM) system between February 2011 and January 2017. Multiple glycaemic variability parameters, including the mean amplitude of glycaemic excursions (MAGE), mean of daily differences (MODD), standard deviation of glucose (SD), and 24-h mean glucose (24-h MG), were calculated from glucose profiles obtained from CGM. Other possible risks for DPN were also examined.Results Of the recruited type 2 diabetic patients, 20.1% (n = 197) presented with DPN, and these patients also had a higher MAGE, MODD, SD, and 24-h MG than patients without DPN (p < 0.001). Using univariate and multiple logistic regression analyses, MAGE and conventional risks including diabetic duration, HOMA-IR, and hemoglobin A1c (HbA1c) were found to be independent contributors to DPN, and the corresponding odds ratios (95% confidence interval) were 4.57 (3.48-6.01), 1.10 (1.03-1.17), 1.24 (1.09-1.41), and 1.33 (1.15-1.53), respectively. Receiver operating characteristic analysis indicated that the optimal MAGE cutoff value for predicting DPN was 4.60 mmol/L; the corresponding sensitivity was 64.47%, and the specificity was 75.54%.Conclusions In addition to conventional risks including diabetic duration, HOMA-IR and HbA1c, increased glycaemic variability assessed by MAGE is a significant independent contributor to DPN in type 2 diabetic patients.
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There is inconsistency in the relationship between glucose variability and diabetic peripheral neuropathy in the literature.
“There is inconsistency in the relationship between glucose variability and DPN in the literature, and some research indicates that for type 2 DM, glucose variability may be regarded as a marker of beta-cell function rather than direct cause of DPN.37–39”
From Glucose time in range and peripheral neuropathy in type 2 diabetes mellitus and chronic kidney disease (2020) · cites this paper as [38]
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Self-citationXu, F., Zhao, L.-H., Wang, X.-H., Wang, C.-H., Yu, C., Zhang, X.-L., Ning, L.-Y., Huang, H.-Y., Su, J., & Wang, X.-Q. (2022) · Figshare · doi:10.6084/m9.figshare.19092606
Self-citationXu, F., Zhao, L.-H., Wang, X.-H., Wang, C.-H., Yu, C., Zhang, X.-L., Ning, L.-Y., Huang, H.-Y., Su, J., & Wang, X.-Q. (2022) · Figshare · doi:10.6084/m9.figshare.19092609
Self-citationXu, F., Zhao, L.-H., Wang, X.-H., Wang, C.-H., Yu, C., Zhang, X.-L., Ning, L.-Y., Huang, H.-Y., Su, J., & Wang, X.-Q. (2022) · Figshare · doi:10.6084/m9.figshare.19092612
Self-citationChen, N., Wang, N., Duan, H., Pan, T., & Zhai, L. (2026) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s615113
Continuous Glucose Monitoring Glucometrics and Their Role in Predicting Diabetes Complications
Schweiger, D. Š., Mozzillo, E., & Battelino, T. (2026) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2026.08.019
- Authors
- Hu, Y.-M., Zhao, L.-H., Zhang, X.-L., Cai, H.-L., Huang, H.-Y., Xu, F., Chen, T., Wang, X.-Q., Guo, A.-S., Li, J.-A., & Su, J.-B.
- Affiliations
- Nantong University (CN)
- Second Affiliated Hospital of Nantong University (CN)
- Venue
- Endocrine
- Published
- 2018-02-06
- Volume
- 60
- Issue
- 2
- Pages
- 292-300
- ISSN
- 0969-711X (ISSN-L)
- 1355-008X
- 1559-0100
- OpenAlex
- W2787636896
- Cited by
- 57
- References
- 48
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 11 · 2023: 4 · 2022: 14 · 2021: 9 · 2020: 10 · 2019: 5 · 2018: 1
- FWCI
- 4.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Endocrine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Scientific Research Program of Nantong (HS2012028 and MS22015065)
- Scientific Research Program of Health and Planning Commission of Jiangsu (H201553)
- Scientific and Educational Program for Prosperity of Health Care of Jiangsu (QNRC2016408)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- diabetic peripheral neuropathy, glycemic variability, type 2 diabetes, continuous glucose monitoring, mean of daily differences, HOMA-IR, HbA1c, diabetes duration, microvascular complications, risk factors
- MeSH terms
- Adult, Aged, Blood Glucose, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Diabetic Neuropathies, Humans, Middle Aged, Peripheral Nervous System Diseases, ROC Curve, Blood Glucose Self-Monitoring, Logistic Models
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