Glucose-lowering medication associated with weight loss may limit the progression of diabetic neuropathy in type 2 diabetes.

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY Journal of the Peripheral Nervous System Pub Date : 2024-10-22 DOI:10.1111/jns.12664

Georgios Ponirakis, Ibrahim Al-Janahi, Einas Elgassim, Rawan Hussein, Ioannis N Petropoulos, Hoda Gad, Adnan Khan, Hadeel B Zaghloul, Mashhood A Siddique, Hamda Ali, Fatima F S Mohamed, Lina H M Ahmed, Youssra Dakroury, Abeer M M El Shewehy, Ruba Saeid, Fadwa Mahjoub, Shaikha N Al-Thani, Farheen Ahmed, Moayad Homssi, Salah Mahmoud, Nebras H Hadid, Aisha Al Obaidan, Iuliia Salivon, Ziyad R Mahfoud, Mahmoud A Zirie, Yousuf Al-Ansari, Stephen L Atkin, Rayaz A Malik

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Abstract

Aim: Obesity is a major risk factor for diabetic peripheral neuropathy (DPN) in type 2 diabetes (T2D). This study investigated the effect of glucose lowering medication associated with weight change on DPN.

Methods: Participants with T2D were grouped based on whether their glucose lowering medications were associated with weight gain (WG) or weight loss (WL). They underwent clinical, metabolic testing and assessment of neuropathic symptoms, vibration perception threshold (VPT), sudomotor function and corneal confocal microscopy (CCM) at baseline and follow-up between 4 and 7 years.

Results: Of 76 participants, 69.7% were on glucose lowering medication associated with WG, and 30.3% were on glucose lowering medication associated with WL. At baseline, participants in the WG group had a significantly longer duration of diabetes (p < .01), higher douleur neuropathique en 4 (DN4) score (p < .0001) and VPT (p = .01) compared with those in the WL group. Over a 56-month period, participants in the WG group showed no significant change in body weight (p = .11), HbA1c (p = .18), triglycerides (p = .42), DN4 (p = .11), VPT (p = .15) or Sudoscan (p = .43), but showed a decline in corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fiber length (CNFL) (p < .0001). Participants in the WL group showed a reduction in weight (p = .01) and triglycerides (p < .05), no change in DN4 (p = .30), VPT (p = .31) or Sudoscan (p = .17) and a decline in the corneal nerve branch density (p < .01).

Conclusions: Participants treated with glucose lowering medication associated with weight gain had worse neuropathy and greater loss of corneal nerves during follow-up, compared to patients treated with medication associated with weight loss.

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与减轻体重相关的降糖药物可能会限制 2 型糖尿病患者糖尿病神经病变的发展。

目的：肥胖是2型糖尿病（T2D）患者发生糖尿病周围神经病变（DPN）的主要风险因素。本研究调查了与体重变化相关的降糖药物对 DPN 的影响：方法：根据服用降糖药是否会导致体重增加（WG）或减轻（WL），对 2 型糖尿病患者进行分组。他们在基线和 4 至 7 年的随访期间接受了临床、代谢测试以及神经病理性症状、振动感知阈值 (VPT)、运动功能和角膜共聚焦显微镜 (CCM) 评估：在 76 名参与者中，69.7% 正在服用与 WG 相关的降糖药物，30.3% 正在服用与 WL 相关的降糖药物。基线时，WG 组参与者的糖尿病持续时间明显更长（P与接受减肥药物治疗的患者相比，接受体重增加相关降糖药物治疗的患者在随访期间神经病变更严重，角膜神经损失更多。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Peripheral Nervous System 医学-临床神经学

CiteScore

6.10

自引率

7.90%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.