The interrelationship between the frequency and severity of entrapment neuropathies and HbA1c in patients with diabetes in short and long term: A retrospective cohort study

Abstract

Aim

Diabetes mellitus (DM) is a significant risk factor for peripheral nervous system disorders, particularly for polyneuropathy and carpal tunnel syndrome (CTS). In this study, we aimed to find whether there was an association between the severity of peripheral neuropathies and blood sugar regulation in diabetics.

Method

We included 347 diabetic patients who were evaluated in our EMG laboratory. We divided the study population into four subgroups based on the glycemic control as in American Diabetes Association (ADA) classification and three classes in Michigan severity stages of diabetic polyneuropathy (DPNP). Possible associations between demographics, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and the severity of DPNP and CTS were analyzed.

Results

Patients with DPNP had higher levels of FBG and HbA1c (p = 0.002 and p < 0.001, respectively). Similarly, patients with entrapment neuropathy also had higher levels of FBG and HbA1c than those without (p = 0.003 and p = 0.004, respectively). Moreover, higher grades of DPNP and CTS were associated with higher mean levels of FBG and HbA1c (p < 0.05 for all analyses). Patients with more impaired glycemic control, categorized according to the ADA classification of HbA1c, had more severe grades of DPNP and CTS (p < 0.05).

Conclusion

Patients with more impaired glycemic control experienced more frequent and severe grades of DPNP and/or CTS. This suggests that achieving individualized treatment targets early may help prevent the onset and progression of these peripheral nervous system complications.

We recommend using HbA1c as a predictor of the electrophysiological severity of peripheral compression neuropathies in diabetic patients.