Glycaemic Trends and Potential Biomarkers in Painful Diabetic Neuropathy

To evaluate the relationship between the diabetic profile and human β-nerve growth factor (HβNGF), calcitonin gene-related peptide (CGRP), endothelin-1 (ET-1), and von Willebrand factor (VWF) in distinguishing painful from painless diabetic neuropathy.

A case-control study.

Department of Diabetic Foot, Baqai Institute of Diabetes and Endocrinology, Karachi, Pakistan, from October 2023 to August 2024.

A total of 150 patients with Type I or II diabetes were recruited after IRB approval. Following informed consent, data on demographics, clinical examination, nerve conduction studies (peroneal, tibial, median, and sural nerves), and biochemical parameters (FBS, RBS, HbA1c, HβNGF, CGRP, ET-1, and VWF) were collected. Based on the NCS and DN4 questionnaire, participants were categorised into controls (no neuropathy), painless neuropathy, and painful neuropathy groups. Data were analysed using IBM SPSS version 23.0, with p <0.05 considered significant.

Patients with painful neuropathy exhibited significantly lower VWF levels (p = 0.002) and higher fasting blood glucose (p = 0.01). Age, BMI, weight, and duration of diabetes differed significantly among the groups. Logistic regression identified duration of diabetes as the only independent predictor of painful neuropathy in both univariate (OR = 1.30) and multivariate analyses (OR = 1.47). FBS showed a positive correlation with diabetes duration (r = 0.188, p = 0.02).

The duration of diabetes independently predicts painful diabetic neuropathy. Reduced VWF levels in patients with painful neuropathy suggest a potential role as a diagnostic biomarker. Further longitudinal studies are recommended.

Diabetes mellitus, Diabetic peripheral neuropathy, β-Nerve growth factor, CGRP, Endothelin-1, von Willebrand factor.