Impact of glycemic variability on early detection of sudomotor dysfunction: Implications for early intervention and personalized treatment.

BACKGROUND

This study investigates the impact of glycemic variability on sudomotor dysfunction in type 2 diabetes mellitus.

METHODS

A total of 206 type 2 diabetes mellitus patients and 34 healthy controls were included. Sweat function (SF) was assessed using electrochemical conductance of hands (HESC) and feet (FESC). Type 2 diabetes mellitus patients underwent continuous glucose monitoring (CGM), and blood glucose variability was analyzed using various metrics. Type 2 diabetes mellitus patients were classified into normal, abnormal, reversible, and persistent abnormal SF groups.

RESULTS

In healthy controls, SF showed no circadian rhythm. Type 2 diabetes mellitus patients with abnormal SF had longer diabetes duration, higher glucose variability, and greater SF impairment (P < 0.05). The reversible group exhibited the largest SF fluctuations (~26 μS) and a significant correlation between glucose variability and SF (P < 0.05). Blood glucose levels of 5-10 mmol/L were associated with improved SF in this group.

CONCLUSIONS

The findings suggest that greater glucose variability correlates with more severe peripheral nerve damage, and controlling blood glucose within 5-10 mmol/L may improve SF, offering insights for personalized treatment strategies in diabetic peripheral neuropathy (DPN) prevention.