Association between Diabetic Neuropathy and Neutrophil Lymphocyte Ratio amongst Type 2 Diabetics

Abstract

Original Research Article Background: The study aimed to evaluate the relationship between Diabetic neuropathy and neutrophil lymphocyte ratio amongst patients with type 2 diabetes. Methodology: The study was conducted as a cross sectional study in outpatient Department of Medicine, Hamidia Hospital Bhopal for a period of 6 months. All the 100 known cases of type 2 diabetes belonging to age group of 18 to 80 years and giving consent were included in the study. Detailed data regarding sociodemographic variables, diabetes duration and treatment was obtained and entered in questionnaire. Height, weight, BMI was recorded. CBC, FBS, PPBS and HbA1c was also conducted. Results: The present study observed no statistically significant association between various baseline variables and Neutrophil to lymphocyte ratio (p>0.05).Neutrophil to lymphocyte ratio were significantly associated with duration of diabetes and presence of neuropathy i.e. NLR were significantly higher in patients with neuropathy and patients with longer duration of diabetes (p<0.05). Diabetic neuropathy was observed to be significantly correlated with neutrophil to lymphocyte ratio and duration of diabetes (p<0.01). Conclusion: Higher neutrophil to lymphocyte ratio may be considered as a prognostic indicator of diabetic neuropathy. This is a cost effective marker that is easily available and can be used in community settings as well as resource poor settings.

Relationship between neutrophil to lymphocyte ratio and diabetic peripheral neuropathy: a systematic review and meta-analysis

“…Initially, 486 records were identified through a combination of database searches and a manual review of article citations. Following the removal of duplicate entries and irrelevant records, a total of 15 studies [3,5,[16][17][18][19][20][21][22][23][24][25][26][27][28] were deemed suitable for inclusion in the systematic review and subsequent meta-analysis. These studies collectively encompassed 4575 patients diagnosed with type 2 diabetes, of which 1708 individuals developed DPN.…”

“…This meta-analysis included 15 studies, of whom seven were conducted in East Asia [3,17,18,20,[26][27][28], three in Egypt [5,16,22], three in India [21,23,25], and two in turkey [19,24]. Regarding the language used in the documents, they were all authored in the English language.…”

“…The general features of the studies, as well as their quality ratings, are shown in Table 1. In total, 14 research compared NLR levels of diabetic patients with and without DPN [5,[16][17][18][19][20][21][22][23][24][25][26][27][28] and five studies reported diagnostic value of NLR in DPN, based on ROC curve analysis [3,16,18,23,26]. NOS score of included studies ranged between 6 and 7.…”

“…Thus, analyzing the relationship between NLR and diabetic neuropathy makes sense. Recent studies have reported significant elevated Neutrophil to lymphocyte ratio (NLR) levels in DPN patients compared to T2D patients without DPN [3,5,[16][17][18][19][20][21][22][23][24][25][26][27][28]. NLR has been used as a novel biomarker and diagnostic tool to test for chronic inflammation.…”

The The Barriers and Facilitators of Physical Activity Participation Among People Living with Type 2 Diabetes

“…Diabetes and its complications, which are categorised with macro vascular complications and micro vascular complications, are major cause of mortality and morbidity (Cunningham et al, 2018;Zheng, Ley, & Hu, 2018). Macro vascular complications of diabetes, including coronary heart disease, stroke and peripheral vascular disease, and micro vascular complications, such as end-stage renal disease (ESRD), retinopathy and neuropathy, along with lower-extremity amputations (LEA), are responsible for much of the burden associated with diabetes (Sjöström, Peltonen, & Jacobson, 2014;Wadhwani et al, 2020). Furthermore, T2DM is associated with psychological problems.…”