Work

HbA 1c and the risk of developing peripheral neuropathy in childhood‐onset type 1 diabetes: A follow‐up study over 3 decades

Year: 2024

Type: article

Abstract: Aims We have evaluated long‐term weighted mean HbA 1c (wHbA 1c ), HbA 1c variability, diabetes duration, and lipid profiles in relation to the development of diabetic peripheral neuropathy (DPN), nephropathy, and retinopathy in childhood‐onset type 1 diabetes. Materials and Methods In a longitudinal cohort study, 49 patients (21 women) with childhood‐onset type 1 diabetes were investigated with neurophysiological measurements, blood tests, and clinical examinations after a diabetes duration of 7.7 (±3.3) years (baseline) and followed with repeated examinations for 30.6 (±5.2) years. We calculated wHbA 1c by integrating the area under all HbA 1c values since the diabetes diagnosis. Lipid profiles were analysed in relation to the presence of DPN. Long‐term fluctuations of HbA 1c variability were computed as the standard deviation of all HbA 1c measurements. Data regarding the presence of other diabetes complications were retrieved from medical records. Results In this follow‐up study, 51% (25/49) of the patients fulfilled electrophysiological criteria for DPN. In nerve conduction studies, there was a deterioration in the amplitudes and conduction velocities for the median, peroneal, and sural nerves over time. Patients with DPN had a longer duration of diabetes, higher wHbA 1c, and increased HbA 1c variability. The lowest wHbA 1c value associated with the development of DPN was 62 mmol/mol (7.8%). The presence of albuminuria and retinopathy was positively correlated with the presence of neuropathy. Conclusions More than half of the patients had developed DPN after 30 years. None of the patients who developed DPN had a wHbA 1c of less than 62 mmol/mol (7.8%).

Source: Diabetes/Metabolism Research and Reviews

DOI: 10.1002/dmrr.3825