title: Relationship Between HbA1c and Complex Regional Pain Syndrome in Stroke Patients With Type 2 Diabetes Mellitus.
abstract: OBJECTIVE
  To investigate the relationship between glycosylated hemoglobin A (HbA1c) and complex regional pain syndrome (CRPS) in stroke patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  A retrospective chart review was performed of stroke patients from January 2012 to December 2013. We reviewed 331 patients and included 200 in the analysis. We divided them into CRPS and non-CRPS groups and compared them by age, gender, stroke lesion, cause of stroke, duration of T2DM, HbA1c (%), National Institutes of Health Stroke Scale score, affected shoulder flexor muscle strength, Fugl-Meyer Assessment score, motricity index, Functional Independence Measure, Korean version of Modified Barthel Index, blood glucose level on admission day, duration from stroke onset to HbA1c check, and duration from stroke onset to three-phase bone scan for CRPS diagnosis. Thereafter, we classified the patients into five groups by HbA1c level (group 1, 5.0%-5.9%; group 2, 6.0%-6.9%; group 3, 7.0%-7.9%; group 4, 8.0%-8.9%; and group 5, 9.0%-9.9%) and we investigated the difference in CRPS prevalence between the two groups.
  
  
  RESULTS
  Of the 200 patients, 108 were in the CRPS group and 92 were in the non-CRPS group. There were significant differences in HbA1c (p<0.05) between the two groups but no significant differences in any other factors. Across the five HbA1c groups, there were significant differences in CRPS prevalence (p<0.01); specifically, it increased as HbA1c increased.
  
  
  CONCLUSIONS
  This study suggests that higher HbA1c relates to higher CRPS prevalence and thus that uncontrolled blood glucose can affect CRPS occurrence in stroke patients with diabetes.
authors.affiliation: Department of Rehabilitation Medicine, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Jong Ho
authors.identifier: 0000-0002-1048-6361
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Rehabilitation Medicine, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Ki Pi
authors.identifier: 0000-0002-6597-5840
authors.initials: KP
authors.lastname: Yu
authors.affiliation: Department of Rehabilitation Medicine, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Yong-Soon
authors.identifier: 0000-0003-4709-3964
authors.initials: YS
authors.lastname: Yoon
authors.affiliation: Department of Rehabilitation Medicine, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Eun Sil
authors.identifier: 0000-0003-1996-4451
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation Medicine, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
authors.forename: Ji Hyun
authors.identifier: 0000-0001-5666-1260
authors.initials: JH
authors.lastname: Jeon
keywords: Complex regional pain syndromes; Diabetes mellitus; Glycosylated hemoglobin A; Stroke