The role of insulin resistance in diabetic neuropathy in Koreans with type 2 diabetes mellitus: a 6-year follow-up study.
OBJECTIVE
We previously reported that insulin resistance, low high-density lipoprotein (HDL) cholesterol, and glycaemic exposure Index are independently associated with peripheral neuropathy in Korean patients with type 2 diabetes mellitus. We followed the patients who participated in that study in 2006 for another 6 years to determine the relationship between insulin resistance and neuropathy.


METHODS
This study involved 48 of the original 86 Korean patients with type 2 diabetes mellitus who were referred to the Neurology clinic for the assessment of diabetic neuropathy from January 2006 to December 2006. These 48 patients received management for glycaemic control and prevention of diabetic complications in the outpatient clinic up to 2012. We reviewed blood test results and the nerve conduction study findings of these patients, taken over a 6-year period.


RESULTS
Low HDL cholesterol and high triglycerides significantly influenced the development of diabetic neuropathy. Kitt value (1/insulin resistance) in the previous study affected the occurrence of neuropathy, despite adequate glycaemic control with HbA1c <7%. Insulin resistance affected the development of diabetic neuropathy after 6 years: insulin resistance in 2006 showed a positive correlation with a change in sural sensory nerve action potential in 2012.


CONCLUSIONS
Diabetic neuropathy can be affected by previous insulin resistance despite regular glycaemic control. Dyslipidaemia should be controlled in patients who show high insulin resistance because HDL cholesterol and triglycerides are strongly correlated with later development of diabetic neuropathy.
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Yu Na
YN
Cho
Department of Neurology, Konyang University College of Medicine, Daejeon, Korea.
Kee Ook
KO
Lee
Department of Neurology, Wonkwang University College of Medicine, Gunpo, Korea.
Julie
J
Jeong
Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea.
Hyung Jun
HJ
Park
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Seung-Min
SM
Kim
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Ha Young
HY
Shin
Department of Neurology, Yonsei University College of Medicine, Yongin, Korea.
Ji-Man
JM
Hong
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Chul Woo
CW
Ahn
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Young-Chul
YC
Choi
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
Insulin resistance; diabetic neuropathy; metabolic syndrome; type 2 diabetes mellitus