Correlation of blood glucose variability with peripheral neuropathy risk in type 2 diabetes patients: a cross-sectional analytical study
DOI:
https://doi.org/10.35816/jiksh.v15i2.329Keywords:
blood glucose variability, diabetic neuropathies, glycemic control, type 2 diabetes mellitus, risk factorsAbstract
Introduction: Blood glucose variability (GV) has emerged as a potential determinant of microvascular complications beyond traditional glycemic markers such as HbA1c. However, evidence regarding its association with diabetic peripheral neuropathy (DPN), particularly in resource-limited settings, remains limited. This study aimed to analyze the correlation between GV and the risk of peripheral neuropathy among patients with type 2 diabetes mellitus (T2DM).
Research Methodology: An analytical cross-sectional study was conducted among 85 patients with T2DM attending primary healthcare facilities in Makassar, Indonesia. Blood glucose variability was assessed using the coefficient of variation (CV), while peripheral neuropathy was evaluated using the Michigan Neuropathy Screening Instrument (MNSI). Bivariate analysis was performed using chi-square and correlation tests, followed by multivariable logistic regression to determine independent associations. Statistical significance was set at α = 0.05.
Results: High GV (CV ≥36%) was significantly associated with peripheral neuropathy in bivariate analysis (OR = 3.46; 95% CI: 1.39–8.59; p = 0.007). In multivariate analysis, GV remained an independent predictor (adjusted OR = 2.98; 95% CI: 1.12–7.91; p = 0.028), whereas HbA1c ≥7% was not statistically significant (AOR = 2.67; 95% CI: 0.92–7.73; p = 0.071). Duration of diabetes showed a positive but non-significant association (AOR = 2.41; 95% CI: 0.89–6.54; p = 0.082).
Conclusion: Blood glucose variability is an independent and clinically relevant predictor of peripheral neuropathy in T2DM patients. These findings support integrating GV assessment into routine diabetes management and highlight the need for strategies to improve glycemic stability and reduce the risk of complications.
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Al Sultan, A., Rattray, Z., & Rattray, N. J. W. (2026). The Application of Omics Technologies in Type II Diabetes Mellitus Research. Current Diabetes Reviews, 22(3). https://doi.org/10.2174/0115733998362669250424162654
Aldafas, R., Vinogradova, Y., Crabtree, T. S. J., Gordon, J., & Idris, I. (2026). The long-term impact of early HbA1c control on nephropathy, neuropathy, and retinopathy in type 2 diabetes: Findings from a large UK observational study. Journal of Diabetes and Its Complications, 40(5), 109292. https://doi.org/10.1016/j.jdiacomp.2026.109292
Battelino, T., Lalic, N., Hussain, S., Ceriello, A., Klobucar, S., Davies, S. J., Topsever, P., Heverly, J., Ulivi, F., Brady, K., Tankova, T., Galhardo, J., Tagkalos, K., Werson, E., Mathieu, C., & Schwarz, P. (2025). The use of continuous glucose monitoring in people living with obesity, intermediate hyperglycemia or type 2 diabetes. Diabetes Research and Clinical Practice, 223, 112111. https://doi.org/10.1016/j.diabres.2025.112111
Chen, L., Huang, L., Zhang, H., Chen, Q., Zhang, Z., Huang, S., Li, F., Guan, J., & Yang, Y. (2025). Natural cyclic glycine-proline supplementation improves clinical outcomes of vascular complications in patients with type 2 diabetes mellitus: An exploratory study. Journal of Functional Foods, 133, 106982. https://doi.org/10.1016/j.jff.2025.106982
Crowards, S., Ryals, J., Heslop, L., Hauser, W., Totta-Griese, G., Madden, T., & Wright, D. E. (2025). TLR4 deletion reduces small fiber sensory abnormalities and nerve degeneration in diabetic male mice. Neuroscience, 589, 268–279. https://doi.org/10.1016/j.neuroscience.2025.10.052
Cutruzzolà, A., Parise, M., Scavelli, F. B., Fiorentino, R., Lucà, S., Di Molfetta, S., Gnasso, A., & Irace, C. (2024). The potential of glucose management indicator for the estimation of glucose disposal rate in people with type 1 diabetes. Nutrition, Metabolism and Cardiovascular Diseases, 34(10), 2344–2352. https://doi.org/10.1016/j.numecd.2024.06.013
De, J., Handa, H., Arya, G., Agrawal, S., Das, A., & Saha, S. (2026). Altered taste perception in Type 2 Diabetes Mellitus: A case-control study on taste thresholds and glycemic control. Journal of Oral Biology and Craniofacial Research, 16(1), 138–145. https://doi.org/10.1016/j.jobcr.2025.11.015
Formichi, C., Caprio, S., Auddino, S., Rizza, F., Paolini, B., Nigi, L., & Dotta, F. (2025). Adherence to the mediterranean diet and risk of hypoglycemia in insulin-treated type 2 diabetic patients. Human Nutrition & Metabolism, 41, 200330. https://doi.org/10.1016/j.hnm.2025.200330
Gandecka-Pempera, A., Uruska, A., Piłaciński, S., Zozulińska-Ziółkiewicz, D., & Araszkiewicz, A. (2025). Association between insulin resistance and sudomotor dysfunction in adults with type 1 diabetes. Endocrine Connections, 14(12). https://doi.org/10.1530/EC-25-0657
Gu, J.-X., Huang, J., Wang, K., Yin, Y., Fang, J.-L., Zhang, A.-M., Li, S.-S., Yao, X.-Q., Yang, M., Zhang, N., Jia, M., & Su, M. (2024). Correlation between circulating lipoprotein(a) levels and cardiovascular events risk in patients with type 2 diabetes. Heliyon, 10(17), e37415. https://doi.org/10.1016/j.heliyon.2024.e37415
Junquera-Godoy, I., Martinez-De-Juan, J. L., Lorente, G. G., Carot-Sierra, J. M., Gomis-Tena, J., Saiz, J., Mateu, R. L., Penalva, G. C. M., Blasco, S. G., Carreño, E. B., Climent, E. S., & Prats-Boluda, G. (2025). Surface electromyography for characterizing neuromuscular changes in diabetic peripheral neuropathy. Journal of Electromyography and Kinesiology, 82, 102991. https://doi.org/10.1016/j.jelekin.2025.102991
Kulecki, M., Naskręt, D., Uruska, A., & Zozulińska-Ziółkiewicz, D. (2025). The Nondipping Blood Pattern in Type 1 Diabetes Mellitus: Pathophysiology, Complications, and Management Strategies. Endocrine Practice, 31(6), 821–828. https://doi.org/10.1016/j.eprac.2025.02.015
Lan, N. S. R., Hiew, J., Chen, P., McEvoy, M., Shah, P., Ferreira, I., Ritter, J. C., Manning, L., Yeap, B. B., Fegan, P. G., Dwivedi, G., & Hamilton, E. J. (2026). Medial arterial calcification of the foot arteries is associated with incident cardiovascular events or all-cause mortality in patients with diabetes-related foot ulceration. Diabetes Research and Clinical Practice, 232, 113108. https://doi.org/10.1016/j.diabres.2026.113108
Mansour, E. Z., Alkhouri, S., Baur, A., & Mousad, A. D. (2025). Glycemic thresholds for surgical site infection risk in orthopaedic trauma: Insights from patients with diabetes mellitus and stress-induced hyperglycemia. Journal of Orthopaedic Reports, 100863. https://doi.org/10.1016/j.jorep.2025.100863
Pantazopoulos, D., Gouveri, E., Ntziachristos, V., & Papanas, N. (2025). Raster Scan Optoacoustic Mesoscopy for detecting microvascular complications in diabetes mellitus: A narrative brief review. Diabetes Research and Clinical Practice, 222, 112095. https://doi.org/10.1016/j.diabres.2025.112095
Sheen, Y. J., Wang, H. C., Sung, C. C., Fu, Y. W., Pan, K. J., Chen, J. P., Hao, T. Te, & Chen, H. M. (2025). Advanced diabetic peripheral neuropathy detection: Validation of expert models and development of active short-wave infrared multispectral imaging techniques. Expert Systems with Applications, 269, 126462. https://doi.org/10.1016/j.eswa.2025.126462
Soe, K. K., & Selvarajah, D. (2025). Cardiac Autonomic Neuropathy and Its Impact on Progression of Diabetic Kidney Disease in Type 1 and Type 2 Diabetes. Kidney Medicine, 7(12), 101149. https://doi.org/10.1016/j.xkme.2025.101149
Srivastava, S., Bisen, A. C., Srivastava, D., & Awasthi, H. (2025). Biomarkers for diabetic peripheral neuropathy: A narrative review of advanced glycation end products. NeuroMarkers, 100149. https://doi.org/10.1016/j.neumar.2025.100149
Syaharuddin, S., Suprapto, S., Arda, D., & Menga, M. K. (2025). Effect of health education on self-care behavior in patients with type 2 diabetes mellitus. Jurnal Ilmiah Kesehatan Sandi Husada, 14(2), 351–359. https://doi.org/10.35816/jiskh.v14i2.1323
Xin, R., Lin, F., Chaoqun, G., Changlian, Z., Xiaoyan, C., Ting, H., Chuntao, W., & Xia, Z. (2025). Advances in nutritional risk screening tools for hospitalized patients with type 2 diabetes mellitus. Human Nutrition & Metabolism, 40, 200312. https://doi.org/10.1016/j.hnm.2025.200312
Yamaguchi, H., Matsumura, T., Sugawa, H., Niimi, N., Sango, K., & Nagai, R. (2024). Glucoselysine, a unique advanced glycation end-product of the polyol pathway and its association with vascular complications in type 2 diabetes. Journal of Biological Chemistry, 300(7), 107479. https://doi.org/10.1016/j.jbc.2024.107479
Yang, J., He, M., Liu, X., Zhou, J., Zhang, X., Li, J., Shao, X., Feng, F., Guan, Y., Li, W., & Zhang, W. (2026). Altered functional connectivity within the pain connectome in type 2 diabetic patients with painful peripheral neuropathy: Evidence from pain matrix hubs. Brain Research Bulletin, 238, 111833. https://doi.org/10.1016/j.brainresbull.2026.111833
Zellers, J., Steger-May, K., Commean, P., Jeong, H.-J., Bullard, E., Mueller, M., & Hastings, M. (2026). Foot-specific exercise intervention for forefoot deformity in individuals with type 2 diabetes and peripheral neuropathy: A randomized controlled clinical trial with 3-year follow-up. Brazilian Journal of Physical Therapy, 30(1), 101563. https://doi.org/10.1016/j.bjpt.2025.101563
Zhang, Y., Liu, L., & Qiao, H. (2024). Continuous glucose data construction and risk assessment application of diabetic retinopathy complications for patients with type 2 diabetes mellitus. SLAS Technology, 29(6), 100221. https://doi.org/10.1016/j.slast.2024.100221
Ziori, M., Tentolouris, A., Eleftheriadou, I., Voudouri, A., Simati, S., Aissopou, E., Anastasiou, I. A., Mitsikostas, D.-D., Theodossiadis, P. G., & Tentolouris, N. (2026). Corneal confocal microscopy and cardiac autonomic neuropathy in individuals with type 1 diabetes mellitus. Journal of Diabetes and Its Complications, 40(4), 109290. https://doi.org/10.1016/j.jdiacomp.2026.109290
Zulfiah, Z., Kadang, Y., & Suprapto, S. (2025). Correlation Between Knowledge and Attitude Toward Treatment Adherence Among Patients with Type 2 Diabetes Mellitus in Makassar, Indonesia. Media Kesehatan Politeknik Kesehatan Makassar, 20(2), 304–309. https://doi.org/10.32382/medkes.v20i2.1709
Zúnica-García, S., Javier Blanquer-Gregori, J. F., Sánchez-Ortiga, R., Chicharro-Luna, E., & Jiménez-Trujillo, M. I. (2024). Association between Mediterranean diet adherence and peripheral artery disease in type 2 diabetes mellitus: An observational study. Journal of Diabetes and Its Complications, 38(11), 108871. https://doi.org/10.1016/j.jdiacomp.2024.108871
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Copyright (c) 2026 Rusli Rusli, Maria Kurni Menga, Rita Erlina, Nurlina Nurlina, Sara Palander

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