Correlation between glycemic variability and sudomotor function in patients with type 2 diabetes

Abstract

Objective To investigate the correlation between glycemic variability and sudomotor function in patients with type 2 diabetes mellitus (T2DM). Methods A total of 395 cases with T2DM in the Department of Endocrinology, Nanjing General Hospital of the PLA from March 2016 to May 2017 were enrolled. According to the electrical skin conductivities (ESC) of hands and feet measured with SUDOSCAN, a conductance analyzer, the patients were divided into two groups: 221 cases with normal sudomotor function (normal group, both ESC of hands and feet >60 μs, including 144 males, 77 females) and 174 cases with abnormal sudomotor function (abnormal group, ESC of hands or feet ≤60 μs, including 104 males and 70 females). All participants were monitored with the continuous glucose monitoring system for consecutive 72 hours. Clinical and biochemical indexes were recorded. Biochemical indexes and glycemic variability parameters were compared between the two groups. Spearman correlation analysis and the multiple linear regression analysis were adopted for statistical analysis. Results (1) Compared with the normal sudomotor function group, the abnormal group were with older age [(59±12) vs (52±13) yrs, t=-5.252, P 9.6% subgroup (r value: 0.058-0.368 vs 0.003-0.282, 0.007-0.237). The correlation coefficients between HESC, FESC, hand mean asymmetry, foot mean asymmetry and glycemic variability parameters were generally larger in male group than those in female group (r value: 0.023-0.215 vs 0.003-0.219). (4) Stepwise multiple linear regression analysis revealed that MAGE, duration of disease and creatinine were the independent risk factors affecting sudomotor function (B=-1.550, -0.758, -0.118, all P<0.05). Conclusion MAGE, duration of disease and creatinine are the independent risk factors affecting sudomotor function in patients with T2DM. Glycemic variability are more likely to affect the sudomotor function in male patients and patients with lower level of HbA1c. Key words: Diabetes mellitus, type 2; Glycemic variability; Sudomotor function; Diabetic peripheral neuropathy