ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2026
Antidiabetic Treatment Intensity and Diabetic Peripheral Neuropathy in a County-Level Metabolic Management Center: A Real-World Cross-Sectional Study.
Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionDiabetic peripheral neuropathy (DPN) is a common disabling complication of type 2 diabetes (T2DM), but real-world data from Chinese county-hospital populations are limited. This study estimated the prevalence of DPN and its associated risk factors, including antidiabetic treatment intensity, in a county-level Metabolic Management Center (MMC) cohort.
methodsThis cross-sectional study enrolled 2420 consecutive outpatients and inpatients with T2DM. DPN was defined as large-fiber neuropathy confirmed by nerve conduction study/electromyography (NCS/EMG) using a standardized MMC protocol; diagnosis did not require neuropathic symptoms or signs. Multivariable logistic and ordinal regression were used to examine associations, with treatment intensity modeled as both a three-tier ordinal and categorical variable. Prespecified sensitivity analyses with progressively extensive covariate adjustment assessed confounding by indication.
resultsThe prevalence of NCS/EMG-defined DPN was 12.5%. Higher antidiabetic treatment intensity was associated with increased odds of DPN (per-tier ordinal odds ratio (OR) 1.86, 95% CI 1.50-2.30, P < 0.001), with similar effect sizes across sensitivity analyses. History of hypothyroidism (OR 1.796, 95% CI 1.183-2.727, P = 0.006), greater neck circumference (OR 1.022 per cm, 95% CI 1.004-1.041, P = 0.020) and lower free thyroxine (fT4, OR 0.967 per pmol/l, 95% CI 0.940-0.994, P = 0.018) were also associated with DPN. Recorded diabetes duration (adjusted OR (aOR) 1.000, 95% CI 0.998-1.001, P = 0.818) and single baseline (HbA1c, aOR 0.979, 95% CI 0.926-1.036) showed no clear independent association, which we interpret cautiously given uniformly poor glycemic control and the limitations of single-timepoint measurement.
conclusionsIn this county-hospital T2DM cohort, higher treatment intensity, hypothyroidism, and greater neck circumference were independently associated with NCS/EMG-defined large-fiber DPN and may inform risk stratification in resource-limited settings. The 12.5% prevalence reflects electrophysiological large-fiber abnormality rather than clinically defined DPN per Toronto criteria, and all observed associations are non-causal and hypothesis-generating.
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