Role of biochemical parameters in prediction of diabetic peripheral neuropathy

 Type 2 diabetes mellitus is the most prevalent form of diabetes seen worldwide. Neuropathy is one of the most common micro-vascular complications of type 2 diabetes mellitus. DPN is considered a main risk factor for diabetic foot leading to amputation, and hence a significant cause of morbidity in diabetes mellitus. Increasing age, longer duration of diabetes and poor glycemic control are well recognized risk factors for DPN. Influence of oxidative stress and corresponding inflammatory changes in tissues in chronic diabetes can be evaluated by certain biochemical parameters. The aim of the present study was to evaluate these biochemical parameters in predicting risk for neuropathy.

 This is a randomized case control study. This study was done in a tertiary care hospital in Andhra Pradesh. The study was conducted for a period of 4 months from the month of June to October 2022. All the subjects were the patents attending medical OPD and demographic characters were noted. The patients were asked for an overnight fast for collecting blood samples for analyzing parameters like fasting plasma glucose, glycosylated hemoglobin, renal and lipid profile. Institutional ethical committee clearance was taken before starting the study. The study includes a total of 200 subjects with 100 cases of diabetic patients with neuropathies compared with 100 controls of diabetic patients without neuropathy for various biochemical parameters. Statistical analysis was done using graph pad prism software for unpaired t- test and p-value.

 There was a significant increase in the levels of fasting plasma glucose (p< 0.0002) glycosylated hemoglobin (p <0.0006), Total Cholesterol (p<0.0017), triglycerides (p <0.0232), creatinine (p<0.0001) and Low-density Lipoprotein cholesterol (LDL-C) (p< 0.0080) in patients with diabetic neuropathy when compared to diabetic patients without neuropathy. And there is significant correlation with duration of diabetes (p<0.0320) and other associated risk factors like hypertension systolic blood pressure (SBP) (p< 0.003) diastolic blood pressure (DBP) (p<0.0001) and Body Mass Index BMI (p<0.002).

 From this study it can be seen that regular screening of diabetic patients using biochemical parameters like glycosylated hemoglobin, lipid profile and creatinine and considering the duration of diabetes and other associated risk factors helps in the prediction and prevention of development of neuropathy at an early stage.