Published: 2018-07-23

A comparative evaluation of blood sugar and glycosylated hemoglobin in clinically manifested diabetic neuropathy

Md. Mubasheer Ali, Ahmed Mohiuddin


Background: It is very well established that tight control of diabetes reduces if not prevents the risk of neuropathy.  The benefit of other mode of therapy like myo- inositol supplementation and aldose reductase inhibitors remain to be established. Objective of present study to compare blood sugar and glycosylated hemoglobin in clinically manifested diabetic neuropathy.

Methods: Hospital based cross sectional study was carried out at Department of General Medicine, from August 2016 to October 2017 among 60 patients of diabetic neuropathy. These patients were subjected thorough evaluation as per the proforma.

Results: As per the blood sugar levels, 15% were normal. As per glycosylated hemoglobin levels, only one patient was found to be normal. Thus, glycosylated hemoglobin showed evidence of poor control more frequently than blood sugar estimation in these patients. Patients with both retinopathy and neuropathy in this study had diabetes mellitus for periods 2 months to 20 years.  (Mean 8.2yrs).  Thus, it can be seen that glycosylated hemoglobin is a more sensitive indicator of poor control of diabetes mellitus than blood sugar. This difference is statistically significant (P <0.05).

Conclusions: Thus, as an integral of diabetic control, glycosylated hemoglobin (HbA1C) estimation is superior to the conventional measures in assessment of control.


Blood sugar, Diabetes, HbA1C

Full Text:



Kownig RJ, Peterson CM, Jones RL, Saudek C, Lehrman M, Cerami A. Correlation of glucose regulation and hemoglobin A1C in diabetes mellitus. N Engl J Med. 1976;295(8):417-20.

American diabetes association. Tests of glycemia in diabetes. Clinical practice recommendations. 2003:107-8.

American diabetes association. American academy of neurology consensus statement. Report and recommendations of the San Antonio conference on diabetic neuropathy. Diabetic Care. 1988;11:592-7.

Samai KC, Tripathy BB. Diabetic neuropathy. J Assoc Physicians India. 1993;suppl 1: 47.

Dyck PJ, Kratz KM, Kames JL, Litchy WJ, Klein R, Pach JM et al. The prevalence by staged, severity of various types of diabetic neuropathy retinopathy, and nephropathy in a population based Cohort: the Rochester diabetic neuropathy study. Neurology. 1993;43:817-24.

Young MJ, Boulton AJ, MacLeon AF, Williams DR, Sonksen PH. A multicenter study of the prevalence of diabetic peripheral neuropathy in the United Kingdom Hospital. Clin Population. Diabetologia. 1993;36:1-5.

Mcleod J. Diseases of the nervous systems Davidson’s principles and practice of medicine: 15th ed. 1987:483-4.

Gabby KH. Glycosylated hemoglobin and diabetes mellitus. Med Clin North Am. 1982;66(6):1309-15.

Ellen Burgh M. Diabetic Neuropathy without manifest. Diabetes. 1962;11:197.

Vercoe S. Detection of diabetic retinopathy in a general practice. Practitioner. 1987;231:263-6.

Young RJ, Mac Intyre CC, Martyn CN, Prescott RJ, Ewing DJ, Smith AF et al. Progression of subclinical polyneuropathy in young patients with IDDM associated with glycemic control of microangiopathy. Diabetologia. 1986;29:156-61.

Gonen B, Rubenstein A, Rochman H, Tanega SP, Horwitz DL. Hemoglobin A1C: An Indicator the metabolic control of diabetic patients. Lancet. 1977;2:734-37.

Matsumoto T, Ohashi Y, Yamada N, Kikuchi M. Hyperglycemia as a major determinant of distal polyneuropathy independent of age and diabetic duration in patients with recently diagnosed diabetes. Diabetes Res Clin Pract. 1994;26(2):109-13.

Price D, O’Malley BP, James MA, Roshan M, Hearnshaw JR. Why are impotent diabetic men not being treated. Pract Diabetes. 1991;8:10-11.

Trivelli LIA. Hemoglobin components in patients with diabetes mellitus. N Engl J Med. 1971;284:353.

Brown MJ, Bird SJ. Natural progression of diabetic polyneuropathy in the Zenarestat study population. Diabetes Care. 2004;27:1153-9.