Association Between Glycemic Control and Diabetic Peripheral Neuropathy Among Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Analytical Study

Background: Diabetic peripheral neuropathy is one of the most common microvascular complications of diabetes mellitus and is associated with substantial morbidity, impaired quality of life, and increased risk of foot ulceration and lower-limb amputation. Chronic hyperglycemia, prolonged disease duration, and associated metabolic comorbidities contribute to progressive peripheral nerve damage and worsening neurological dysfunction. Objective: To determine the association between glycemic control and diabetic peripheral neuropathy and to identify clinical predictors of poor neuropathic outcomes among patients with diabetes mellitus. Methods: This cross-sectional analytical study was conducted at the University of Lahore Teaching Hospital and included 206 patients with diabetes mellitus. Demographic, biochemical, and clinical variables including HbA1c, duration of diabetes, body mass index, blood pressure, fasting glucose, chronic kidney disease, hypertension, smoking status, vibration perception, and monofilament test findings were assessed. Logistic regression analysis was performed to estimate odds ratios and 95% confidence intervals for predictors of poor clinical outcome. Results: The mean age of participants was 54.8 ± 12.6 years, and the mean HbA1c level was 8.4 ± 1.7%. Poor glycemic control (HbA1c ≥7.0%) was present in 70.9% of participants and was significantly associated with poor clinical outcomes (OR 2.84, 95% CI 1.52–5.31, p=0.001). Each 1% increase in HbA1c increased the odds of poor neuropathic outcome by 42% (OR 1.42, 95% CI 1.18–1.71, p<0.001). Diabetes duration ≥10 years (OR 2.36, 95% CI 1.32–4.21, p=0.004) and chronic kidney disease (OR 1.91, 95% CI 1.02–3.59, p=0.043) were also significantly associated with adverse neuropathic outcomes. Reduced vibration perception and abnormal monofilament test findings were significantly more common among patients with poor outcomes (p<0.001). Conclusion: Poor glycemic control, prolonged diabetes duration, and chronic kidney disease were significant predictors of diabetic peripheral neuropathy and adverse neuropathic outcomes. Early neuropathy screening and optimization of glycemic control may help reduce progression of neurological complications in diabetic patients.