Abstract
Objective To investigate the relationship between hemoglobin levels and diabetic peripheral neuropathy (DPN) in type 2 diabetes mellitus (T2DM). Methods 1511 patients with T2DM were included in the study. DPN was diagnosed based on symptoms, signs, and laboratory tests. Hemoglobin was defined as both a continuous variable and a quartile category variable. We compared patient characteristics between the no diabetic peripheral neuropathy (NDPN) and DPN groups. Logistic regression was conducted to investigate the association of DPN with hemoglobin in all T2DM patients. Linear regression was also performed to investigate the impact of hemoglobin on the vibrating perception threshold (VPT). Results Compared with the NDPN group, hemoglobin level in the DPN group was significantly lower (118.54 ± 16.91 versus 131.62 ± 18.32 g/L, P < 0.01). The prevalence of DPN increased by 50.1% (95% CI: 42.2–57.0%; P < 0.001) per standard deviation decrease in hemoglobin. Compared to the highest quartile of hemoglobin, the lower quartiles were associated with a significantly increased risk of DPN in the entire T2DM population (all P < 0.01). A per unit decrease in hemoglobin leads to a 0.12 (95% CI: 0.07–0.168) unit increase in VPT after adjustment for possible confounders (P < 0.001). Conclusions Lower hemoglobin levels were associated with increased prevalence of DPN and higher VPT.
Highlights
It is estimated that there are 382 million people living with diabetes globally, and this number will rise to 592 million by 2035, as estimated by the International Diabetes Federation [1]
In this large retrospective sample of patients with type 2 diabetes mellitus (T2DM) in China, lower Hb levels were associated with an increased risk of diabetic peripheral neuropathy (DPN) and a higher value of vibrating perception threshold (VPT)
Decrease in Hb was associated with an increase in the prevalence of DPN by 50.1%
Summary
It is estimated that there are 382 million people living with diabetes globally, and this number will rise to 592 million by 2035, as estimated by the International Diabetes Federation [1]. Individuals with diabetes are at increased risk of developing diabetic peripheral neuropathy (DPN)—a microvascular complication that may lead to diabetic foot disorders and even lower limb amputations. In a large cohort of people with DPN in the UK, 7% developed a diabetic foot wound after 1 year [2]. In a prospective study with long-term follow-up, the prevalence of DPN increased from 7.5% at baseline to 45% after 25 years [3]. DPN can be detected by vibrating perception threshold (VPT). Evidence has suggested that the VPT test appears to be an appropriate and reliable measure for screening DPN [4, 5]
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