The changeable dynamics between glycaemic control and neuropathy risk across the lifespan of Saudi diabetic patients; A survey in diabetes healthcare facility

BACKGROUND AND AIMS: Peripheral neuropathy is a common diabetic complication. It is linked to poor glycaemic control and longer duration of diabetes. We explored the association between HbA1c and neuropathy risk considering the duration of diabetes in a sample of Saudi diabetic patients. METHOD: We conducted a monofilament test on 343 diabetic patients referred to our specialist diabetology centre in Saudi Arabia. We utilized a multiple generalized logistic regression model with a binary outcome related to neuropathy complications. RESULTS: We found that over four out of every five patients have peripheral neuropathy. The interaction between HbA1c and duration was significant (estimate = −0.02802, P = 0.00534), a positive association between neuropathy and both HbA1c (increased risk by 46.2%, P = 0.03222) and DM duration (increased risk by 19.6%, P = 0.04497). CONCLUSIONS: The shorter the duration of diabetes, the more positive the relationship between HbA1c and peripheral neuropathy. In patients living for over 40 years with diabetes, HbA1c was higher among those who did not have peripheral neuropathy. It could be argued that this is an artefact of survival as poorer glycaemic control will likely result in higher mortality in earlier years of the diabetes career.