The relationship between blood glucose excursions and painful diabetic peripheral neuropathy: a pilot study

Aims Peripheral neuropathy affects 30% of Type 1 diabetic patients. Unfortunately, 10–20% of affected patients have disabling symptoms. The aim of this study was to examine the relationship between blood glucose excursions and pain in patients with symptomatic diabetic neuropathy. Methods Twenty Type 1 diabetic patients with peripheral neuropathy (10 painful and 10 painless) wore a continuous glucose monitoring system for 3 days. Symptomatic patients kept a daily pain score diary. The mean amplitude of glycaemic excursions (MAGE) and the M‐values (measure of glucose deviations from an arbitrarily selected point) were calculated. Results Groups were matched for (mean ± sd) age: 52.0 ± 11.1 years; duration of diabetes: 24.8 ± 10.7 years; HbA1c: 9.7 ± 2.3%; duration of neuropathy: 5.6 ± 2.6 years; and CGMS performance. The painful group had a greater mean glucose (12.1 ± 2.9 mmol/l vs. 9.3 ± 1.9 mmol/l, P = 0.02), a greater M‐value (68.4 vs. 31.1, P = 0.02) and more glycaemic excursions (13 vs. 10, P