title: Association of Diabetic Neuropathy with Duration of Type 2 Diabetes and Glycemic Control.
abstract: BACKGROUND
  Diabetes mellitus is associated with severe microvascular and macrovascular complications with major implications for public health. Diabetic neuropathy is a very problematic complication of diabetes mellitus. It is associated with severe morbidity, mortality, and a huge economic burden. The present study was designed with two aims: 1) to analyze the association of diabetic neuropathy with the glycemic index (levels of fasting blood glucose, random blood glucose, and Hb1Ac) in patients with Type 2 diabetes, and 2) to analyze the association of diabetic neuropathy with time passed since the diagnosis of diabetes.
  
  
  METHODS
  This case-control study was undertaken between June 2013 and February 2015 in the Armed Forces Institute of Rehabilitation Medicine (AFIRM), Rawalpindi, Pakistan. Type 2 diabetics with an age range of 30-60 years were recruited from outpatient departments of AFIRM, Rawalpindi. Data were collected and recorded on a form with four sections recording the following: 1) demographics of patients and number of years passed since diagnosis of diabetes; 2) clinical examination for touch, pressure, power, pain, vibration, and ankle reflex; 3) nerve conduction studies for motor components of the common peroneal nerve and tibial nerve and the sensory component of median nerve and sural nerve; 4) glycemic index, including fasting blood glucose levels (BSF), random blood glucose (BSR) levels, and HbA1c levels. Data were analyzed in SPSS v. 20. Chi-square and phi statistics and logistic regression analysis were run to analyze associations between diabetic neuropathy and time passed since diagnosis of diabetes and glycemic index.
  
  
  RESULTS
  In total, 152 patients were recruited. One-half of those patients had neuropathy (76 patients) and the other half (76 patients) had normal nerve function. The mean (standard deviation [SD]) duration of diabetes was nine years (6.76), BSF levels 7.98 mmol/l (2.18), BSR 9.5 mmol/l (3.19), and HbA1c 6.5% (2.18). Logistic regression analysis predicted 87.5% of the model correctly. Duration since the diagnosis of diabetes and HbA1c levels were significantly associated with the diagnosis of neuropathy in diabetics.
  
  
  CONCLUSIONS
  The presence of diabetic neuropathy was significantly associated with HbA1c levels and the duration of diabetes.
authors.affiliation: Final year MBBS Student, Yusra Medical & Dental College Near Kahuta Morr, GT Road, P.O Humak, Islamabad.
authors.forename: Muhammad Umer
authors.initials: MU
authors.lastname: Nisar
authors.affiliation: Associate Professor, Dept. of Physiology, Yusra Medical & Dental College Near Kahuta Morr, GT Road, P.O Humak, Islamabad.
authors.forename: Ambreen
authors.initials: A
authors.lastname: Asad
authors.affiliation: Final year MBBS Student, CMH Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Waqas
authors.affiliation: Fourth year MBBS Student, Yusra Medical & Dental College Near Kahuta Morr, GT Road, P.O Humak, Islamabad.
authors.forename: Nazia
authors.initials: N
authors.lastname: Ali
authors.affiliation: Wah Medical College, , POF Hospital Wah Cantt. Pakistan.
authors.forename: Anam
authors.initials: A
authors.lastname: Nisar
authors.affiliation: Fourth year MBBS Student , Yusra Medical & Dental College Near Kahuta Morr, GT Road, P.O Humak, Islamabad.
authors.forename: Mohsin A
authors.initials: MA
authors.lastname: Qayyum
authors.affiliation: Fourth year MBBS, Yusra Medical & Dental College Near Kahuta Morr, GT Road, P.O Humak, Islamabad.
authors.forename: Hafsa
authors.initials: H
authors.lastname: Maryam
authors.affiliation: Fourth year MBBS Student, Yusra Medical & Dental College Near Kahuta Morr, GT Road, P.O Humak, Islamabad.
authors.forename: Mohsin
authors.initials: M
authors.lastname: Javaid
authors.affiliation: Fourth year MBBS Student, Yusra Medical & Dental College Near Kahuta Morr, GT Road, P.O Humak, Islamabad.
authors.forename: Mohsin
authors.initials: M
authors.lastname: Jamil
keywords: diabetes; diabetes mellitus; diabetic neuropathy; peripheral neuropathy; type 2 diabetes