The Correlation Between HbA1c and Neuropathy Disability Score in Type 2 Diabetes

Ilsa Hunaifi, I Gusti Ngurah Ommy Agustriadi, I Gede Yasa Asmara, Catharina Budyono


Background: World Health Organization (WHO) estimates the incidence of type 2 diabetes in Indonesia would increase to 21.3 million in 2030. Diabetes has a chronic complications, including peripheral neuropathy. The degree of neuropathy was assessed through the Neuropathy Disability Score (NDS). In contrast, haemoglobin A1c is glycated haemoglobin used to monitor the glucose levels of diabetic patients in the last 2 or 3 months. The relationship between HbA1c and diabetic neuropathy carried out by electrodiagnosis showed that HbA1c and age were the main predictors of diabetic neuropathy. However, electrodiagnosis is still considered costly. Research is needed to determine the relationship between HbA1c and NDS to reduce morbidity. This study aims to determine the relationship between the severity of diabetic neuropathy as measured by NDS with HbA1c level in type 2 Diabetes. Methods: this cross-sectional study involved correlation analysis.. The collected data were analyzed with the Spearman correlation test. Results: approximately 56 diabetic patients were involved in this study. Patients were recruited from the internal medicine outpatient ward from the West Nusa Tenggara General Hospital. The mean age was 59.55 (SD 9.48) with 57.1% female; the median duration of diabetes was 5.5 years. The median NDS score is 7.5 and the median HbA1c value is 8.65. Spearman correlation analysis shows a correlation coefficient of 0.487 with a value of p = 0.000. Conclusion: there is a relationship between HbA1c level and the severity of diabetic neuropathy in Type 2 DM.


HbA1c; neuropathy; endocrinology; diabetes mellitus


International Diabetes Federation, IDF Diabetes Atlas 8ed, 2017,, accessed Oct 14, 2019

Departemen Kesehatan Republik Indonesia, Riset Kesehatan Dasar, 2013, accessed Oct 14, 2019.

Perkeni, Konsensus Pengelolaan dan Pencegahan Diabetes Melitus tipe 2 di Indonesia, 2006,, accessed Oct 14, 2019.

Powers AC. Diabetes mellitus. In: Fauci AS, Kasper DL, Longo DL, et al (ed). Harrisons principle of internal medicine. 17th ed. New York: Mc Graw-Hill Medical, 2015. p. 2275-304.

Boulton AJM, Vinik AI, Arezzo JC, et al. Diabetic neuropathies. Diabetes Care. 2005;28;956-62.

Yang Z, Chen R, Zhang Y, et al. Scoring systems to screen for diabetic peripheral neuropathy (Protocol). Cochrane Database of Systemic Reviews. 2014;3:1-31.

Lee WJ, Jang S, Lee SH, Lee HS. Correlation between the severity of diabetic peripheral polyneuropathy and glycosylated hemoglobin levels: A quantitative study. Ann Rehabil Med. 2016;40 (2):263-70.

Meijer JWG, Sonderen E, Blaauwwikel EE, et al. Diabetic neuropathy examination. Diabetes Care. 2000;23;750-3.

Yuan H, Li X, Wan G, et al. Type 2 diabetes epidemic in East Asia: a 35-year systematic trend analysis.Onco Target. 2018;9(6):6718-27.

Nisar MU, Asad A, Waqas A, et al. Association of diabetic neuropathy with duration of type 2 diabetes and glycemic control. Cureus. 2015;7(8):e302.

Zilliox LA, Ruby SA, Singh S, Zhan M, Russell JW. Clinical neuropathy scale in neuropathy associated with impaired glucose tolerance. J Diabetes Complication. 2015;29(3):372-7.

Stem MS, Blachley TS, Shtein RM, Herman WH, Gardner TW, Stein JD. Impact of diagnosing diabetic complications on future haemoglobin A1c levels. J Diabetes Complication. 2016;30(2):323-8.

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