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The impact of glycemic variability on diabetic peripheral neuropathy

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Abstract

Mean glucose values alone cannot explain the patterns of morbidity and mortality due to dysglycemia in diabetes. Development of continuous glucose monitoring systems has improved the analysis and interpretation of glycemic variability. The roles of glycemic components other than constant hyperglycemia in diabetic complications must be investigated because large clinical studies have indicated that risk factors besides the average glucose value of HbA1c are involved in chronic macrocomplications/microcomplications of diabetes. Among these complications, the pathogenesis of diabetic peripheral neuropathy is particularly complex, and several factors related to glucose and nonglucose pathways have been suggested as risk factors. There is little information regarding the effect of glycemic variability on diabetic peripheral neuropathy, unlike other microvascular complications of retinopathy and nephropathy, and whether glycemic variability causes harmful effects is still a matter of debate. In this review, we discuss the relationships between glycemic variability and diabetic peripheral neuropathy, focusing on somatosensory peripheral neuropathies rather than autonomic neuropathies.

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Acknowledgments

We thank the Research Institute of Clinical Medicine of Chonbuk National University—Biomedical Research Institute of Chonbuk National University Hospital for partly supporting the process of manuscript writing and Dr. Nigel Calcutt (UCSD) for assistance with this manuscript.

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  1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, South Korea

    Heung Yong Jin, Kyung Ae Lee & Tae Sun Park

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Correspondence to Tae Sun Park.

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Jin, H.Y., Lee, K.A. & Park, T.S. The impact of glycemic variability on diabetic peripheral neuropathy. Endocrine 53, 643–648 (2016). https://doi.org/10.1007/s12020-016-1005-7

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