Observational studyCardiovascular diabetology2018
HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients.
Observational study in Cardiovascular diabetology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
71 citing papers in PubMed, 5 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- Long-term HbA1c variability and macro-/micro-vascular complications in type 2 diabetes mellitus: a meta-analysis update.Acta diabetologica · 2023Pooled it
- Associations of serum low-density lipoprotein and systolic blood pressure levels with type 2 diabetic patients with and without peripheral neuropathy: systemic review, meta-analysis and meta-regression analysis of observational studies.BMC endocrine disorders · 2019Pooled it
- Pooled it
- Establishment and validation of a clinical model for predicting diabetic ketosis in patients with type 2 diabetes mellitus.Frontiers in endocrinology · 2022Trial
- To Correlate the Relationship between Diabetic Retinopathy, Diabetic Peripheral Neuropathy, and Its Association with Glycemic Control in Rural Population of South India.Annals of African medicine · 2026Observational
- Exploration of a Multimodal Machine Learning Model Integrating Ultrasound and Clinical Indicators for the Diagnosis of Diabetic Peripheral Neuropathy.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026Article
- Diabetic neuropathy's immune-metabolic network: mechanistic complexity, therapeutic challenges, and the path forward.Frontiers in immunology · 2026Review
- Antidiabetic Activity of Amaranthus hybridus Leaf-based Diet in High-fat Diet and Streptozotocin-induced Diabetic Rats.Plant foods for human nutrition (Dordrecht, Netherlands) · 2025Article
- A Nationwide Study on the Prevalence of Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus in Greece-The PRENEDIG Study.Journal of clinical medicine · 2025Article
- Impact of HbA1c variability and time-in-range fluctuations on large and small nerve fiber dysfunction in well-controlled type 2 diabetes: A prospective cohort observational study.Journal of diabetes investigation · 2025Observational
- Diabetic Foot Care Education and Practices: A Knowledge, Attitudes, and Practices Questionnaire-Based Study.Cureus · 2025Article
- Increased blood urea nitrogen levels and compromised peripheral nerve function in patients with type 2 diabetes.World journal of diabetes · 2025Article
- Crumbling Pathogenesis and Biomarkers for Diabetic Peripheral Neuropathy.Biomedicines · 2025Review
- Early Neuropathy as a Predictor of Subclinical Diabetic Nephropathy in Well-Controlled Type 2 Diabetic Patients: A Cross-Sectional Study.Journal of diabetes research · 2025Article
- Predict and prevent microvascular complications of type 2 diabetes: a cross-sectional and longitudinal study in Chinese communities.Frontiers in endocrinology · 2025Article
- Wearable non-invasive neuroprosthesis for targeted sensory restoration in neuropathy.Nature communications · 2024Article
- The clinical importance of measuring glycaemic variability: Utilising new metrics to optimise glycaemic control.Diabetes, obesity & metabolism · 2024Review
- Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDiabetic complications may be associated with impaired time-dependent glycemic control. Therefore, long-term glycemic variability, assessed by variations in haemoglobin A1c (HbA1c), may be a potential risk factor for microvascular complications, such as diabetic peripheral neuropathy (DPN). We investigated the association of HbA1c variability with DPN in patients with type 2 diabetes.
methodsIn this cross-sectional study, 563 type 2 diabetic patients who had been screened for DPN and undergone quarterly HbA1c measurements during the year preceding enrolment were recruited. DPN was confirmed in patients displaying both clinical manifestations of neuropathy and abnormalities in a nerve conduction evaluation. HbA1c variability was assessed by the coefficient of variation of HbA1c (CV-HbA1c), and the mean of HbA1c (M-HbA1c) was calculated. In addition, medical history and clinical data were collected.
resultsAmong the recruited patients, 18.1% (n = 102) were found to have DPN, and these patients also presented with a higher CV-HbA1c than the patients without DPN (p < 0.001). The proportion of patients with DPN increased significantly from 6.9% in the first to 19.1% in the second and 28.5% in the third tertile of CV-HbA1c (p for trend < 0.001). After adjusting for initial HbA1c, M-HbA1c and other clinical factors via multiple logistic regression analysis, the odds ratios (ORs) for DPN in the second and third versus those in the first CV-HbA1c tertile were 3.61 (95% CI 1.62-8.04) and 6.48 (2.86-14.72), respectively. The area under the receiver operating characteristic (ROC) curve of CV-HbA1c was larger than that of M-HbA1c, at 0.711 (95% CI 0.659-0.763) and 0.662 (0.604-0.721), respectively. ROC analysis also revealed that the optimal cutoff value of CV-HbA1c to indicate DPN was 15.15%, and its corresponding sensitivity and specificity were 66.67% and 65.73%, respectively.
conclusionsIncreased HbA1c variability is closely associated with DPN in type 2 diabetic patients and could be considered as a potent indicator for DPN in these patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.