Objective: Previous studies have indicated that in addition to poor glycemic control, glucose variability, obesity and hypertension may also have impacts on DPN in T2DM patients. Not much researches have been taken on T1DM patients. Our study aims to use the data derived from CGMs to assess the association between DPN and glucose variety as well as to find out the potential risk factors for DPN among T1DM patients.
Methods: In this cross-sectional study, a total of 116 type 1 diabetes inpatients were recruited. Patients age range from 14 to 75 years old. All patients were screened for DPN and then divided into 2 groups, DPN and non-DPN group. A 3-day CGMs was conducted on each patient. Information regarding BMI, smoking and drinking habits, medical history were collected from the patients’ medical record book.
Results: 1. Among the type 1 diabetes patients enrolled in our study, the average age is 47.8 years old, with a known diabetes duration of 9.56 years. 40 (34.48%) presented with DPN. The prevalence of DPN increased steadily with increasing duration of diabetes, from 12.1% in those diagnosed diabetes within 5 years to 53.7% in those have diabetes longer than 10 years.
2. Compared with the control group, DPN patients are older, have longer duration, higher BMI, waist circumstance, HbA1c, GA and lower TIR (p<0.05). The prevalence of hypertension, carotid artery plaque, current drinking and smoking were higher in DPN group (p < 0.05). Meanwhile, glucose variability, evaluated by SD and MAGE; insulin function are comparable between two groups(p<0.05)
3. Multivariate logistic regression analysis showed that TIR quartiles(Q1: >71%; Q2: 56-71%; Q3: 41-56%; Q4≤41%) (OR 2.18, CI 1.35-3.51, p =0.001) and duration (OR 1.17, CI 1.08-1.27, p <0.001)were significantly correlating with DPN.
Discussion: In T1DM patients, glycemic variability is not a risk factor for DPN. TIR is a significantly independent risk factor for DPN. Components of the metabolic syndrome may also play an important role in the development of DPN.
W. Shen: None. F. Liu: None.