T2DM: hypoglycaemic events are independent risk factors of diabetic peripheral neuropathy

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  • In patients with type 2 diabetes mellitus (T2DM), previous hypoglycaemic events severe enough to require an emergency department visit or hospitalisation are associated with an increased risk for diabetic peripheral neuropathy (DPN).
  • The risk increased together with the frequency of hypoglycaemic events.

Why this matters

  • No previous studies have determined whether hypoglycaemia is associated with the risk for DPN in patients with T2DM.

Key results

  • A total of 78 patients (2.8%) had reported at least 1 episode of severe hypoglycaemia.
  • Compared with patients without hypoglycaemia, the risk for DPN was significantly higher in patients with hypoglycaemia (OR, 4.54; P<.001).
  • The risk remained statistically significant even after adjustment for confounders (OR, 2.03; P=.010).
  • The risk for DPN appeared substantially greater in patients with 2 or more severe hypoglycaemic events (OR, 2.77; P=.038).
  • After adjustment for confounders, patients with HbA1c levels ≥7% and previous hypoglycaemic episodes had a significantly increased risk for DPN (OR, 2.62; P=.008).

Study design

  • Cross-sectional, hospital-based observational study enrolled patients with T2DM (n=2733; age, >20 y) to evaluate whether previous hypoglycaemic events are associated with an increased risk for DPN.
  • DPN was determined using the Michigan Neuropathy Screening Instrument.
  • Funding: Taichung Veterans General Hospital.


  • Cross-sectional design.
  • DPN diagnosis not confirmed by tests.