Development and Validation of Risk Predicting Model for Severe Diabetic Peripheral Neuropathy Based on Glucose Variability Parameters

Fan ZHANG; Weichang GUO; Hong TAN; Hejia YIN; Luping PENG; Yan ZHAO; Huifang LI

doi:10.12259/j.issn.2095-610X.S20230526

Volume 44 Issue 5

May 2023

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Fan ZHANG, Weichang GUO, Hong TAN, Hejia YIN, Luping PENG, Yan ZHAO, Huifang LI. Development and Validation of Risk Predicting Model for Severe Diabetic Peripheral Neuropathy Based on Glucose Variability Parameters[J]. Journal of Kunming Medical University, 2023, 44(5): 53-59. doi: 10.12259/j.issn.2095-610X.S20230526

Citation:

Fan ZHANG, Weichang GUO, Hong TAN, Hejia YIN, Luping PENG, Yan ZHAO, Huifang LI. Development and Validation of Risk Predicting Model for Severe Diabetic Peripheral Neuropathy Based on Glucose Variability Parameters[J]. Journal of Kunming Medical University, 2023, 44(5): 53-59. doi: 10.12259/j.issn.2095-610X.S20230526

Citation:

Fan ZHANG, Weichang GUO, Hong TAN, Hejia YIN, Luping PENG, Yan ZHAO, Huifang LI. Development and Validation of Risk Predicting Model for Severe Diabetic Peripheral Neuropathy Based on Glucose Variability Parameters[J]. Journal of Kunming Medical University, 2023, 44(5): 53-59. doi: 10.12259/j.issn.2095-610X.S20230526

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Development and Validation of Risk Predicting Model for Severe Diabetic Peripheral Neuropathy Based on Glucose Variability Parameters

doi: 10.12259/j.issn.2095-610X.S20230526

The 2nd Dept. of Endocrinology，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2022-12-19
Available Online: 2023-05-11
Publish Date: 2023-05-25

Abstract

Abstract

Objective To develop and validate a risk prediction model for severe DPN in patients with type 2 diabetes using glucose variability parameters, and to provide the evidence for the prevention and treatment of diabetic chronic complications. Methods The medical records from 323 inpatients with T2DM who met the inclusion criteria were collected in the First Affiliated Hospital of Kunming Medical University from April 2019 to May 2020. Based on the professional sensory threshold measured, patients were divided into none-sever DPN group and severe DPN group. Lasso regression model was used to select risk factors. A risk prediction models for severe DPN was established and shown as a nomogram. ROC curve, calibration curve and decision curve analysis was used to validate the model. Results Age, smoking, dyslipidemia, HbA1c and TIR were significant predictors of severe DPN in type 2 diabetes patients, and TIR was an independent risk factor for severe DPN. An assessing model discrimination was established by using ROC curves with AUC = 0.653 （95%CI = 0.592 - 0.715, P < 0.05）. The Hosmer-Lemeshow test was used to determine the model fit with P value 0.074. Conclusion TIR can be a significant predictor of the severe DPN in patients with T2DM, and the clinical prediction model established on the basis of TIR has the fair accuracy. It is recommended to actively intervene in the patients with a risk of severe DPN greater than 20% （score > 250） evaluated by the model.
- Type 2 diabetes,
- Glucose variability parameters,
- Diabetic peripheral neuropathy

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References(16)

References

[1]	Caroline A Abbott,Rayaz A Malik,Ernest R E van Ross,et al. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the UK[J]. Diabetes Care,2011,34(10):2220-2224. doi: 10.2337/dc11-1108
[2]	Nanna B Finnerup,Simon Haroutounian,Peter Kamerman,et al. Neuropathic pain:An updated grading system for research and clinical practice[J]. Pain,2016,157(8):1599-1606. doi: 10.1097/j.pain.0000000000000492
[3]	Xu Feng,Zhao Li-Hua,Su Jian-Bin,et al. The relationship between glycemic variability and diabetic peripheral neuropathy in type 2 diabetes with well-controlled HbA1c[J]. Diabetology & Metabolic Syndrome,2014,6(1):139.
[4]	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华糖尿病杂志,2021,13(4):315-409.
[5]	Rodica,Pop-Busui,Andrew J M,et al. Diabetic neuropathy: A position statement by the American Diabetes Association[J]. Diabetes Care,2017,40(1):136-154. doi: 10.2337/dc16-2042
[6]	中国成人血脂异常防治指南修订联合委员会. 中国成人血脂异常防治指南(2016年修订版)[J]. 中华心血管病杂志,2016,44(10):833-853. doi: 10.3760/cma.j.issn.0253-3758.2016.10.005
[7]	Vinod P Balachandran,Mithat Gonen,Joshua Smith,et al. Nomograms in oncology:More than meets the eye[J]. The Lancet Oncology,2015,16(4):173-180. doi: 10.1016/S1470-2045(14)71116-7
[8]	Liu S,Zheng H,Zhu X,et al. Neutrophil-to-lymphocyte ratio is associated with diabetic peripheral neuropathy in type 2 diabetes patients[J]. Diabetes Res Clin Pract,2017,130(1):90-97.
[9]	Callaghan B C,Gallagher G,Fridman V,et al. Diabetic neuropathy: What does the future hold?[J]. Diabetologia,2020,63(5):891-897. doi: 10.1007/s00125-020-05085-9
[10]	Feldman E L,Callaghan B C,Pop Busui R,et al. Diabetic neuropathy[J]. Nat Rev Dis Primers,2019,5(1):42. doi: 10.1038/s41572-019-0097-9
[11]	Clair,Carole,Cohen,Marya J,et al. The effect of cigarette smoking on diabetic peripheral neuropathy: A systematic review and meta-analysis[J]. Journal of General Internal Medicine,2015,30(8):1193-1203. doi: 10.1007/s11606-015-3354-y
[12]	Hu Yu-Ming,Zhao Li-Hua,Zhang Xiu-Lin,et al. Association of glycaemic variability evaluated by continuous glucose monitoring with diabetic peripheral neuropathy in type 2 diabetic patients[J]. Endocrine,2018,60(2):292-300. doi: 10.1007/s12020-018-1546-z
[13]	Paul. Mitochondrial dysfunction in diabetic neuropathy: A series of unfortunate metabolic events[J]. Current Diabetes Reports,2015,15(11):89. doi: 10.1007/s11892-015-0671-9
[14]	Kristin Ørstavik,Barbara Namer,Roland Schmidt,et al. Abnormal function of C-fibers in patients with diabetic neuropathy[J]. The Journal of Neuroscience:The Official Journal of the Society for Neuroscience,2006,26(44):11287-94. doi: 10.1523/JNEUROSCI.2659-06.2006
[15]	Yoshiaki Suzuki,Jun Sato,Minoru Kawanishi,et al. Tissue glucose level modulates the mechanical responses of cutaneous nociceptors in streptozotocin-diabetic rats but not normal rats in vitro[J]. Pain,2002,99(3):475-484. doi: 10.1016/S0304-3959(02)00244-0
[16]	Fitzgerald M,Saville B R,Lewis R J. Decision curve analysis[J]. JAMA,2015,313(4):409-410. doi: 10.1001/jama.2015.37

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