Analysis of Reasons For Readmission of Diabetic Patients: 2015-2019

Abstract Background: Among patients with diabetes who had been hospitalized, 30% had twice or more hospitalisations rate, accounting for more than 50% of total hospitalizations and hospitalization expense. The purpose of our study was to to find available strategies to reduce the readmission rate of diabetics in rural areas.Methods: This retrospective single-center study used the data from Yongchuan Hospital of Chongqing Medical University. The t-test and the chi-square test or Fisher's exact test were used to compare continuous and categorical variables, respectively. We used the Spearman correlation coefficient to examine the relationship between variables. Multiple linear regression was performed to analyze the influencing factors of hospitalisation time, and dummy variables were set for categorical independent variables. Results: There were a total of 1721 readmissions during a five-year period; among them, 829 were females and 892 males. The readmission rate of diabetic patients in the endocrinology department was 32.40%. The age, times of hospitalisation, and duration of all subjects were 64.67 ± 13.82, 2.69 ± 1.41 and 10.60 ± 6.78, respectively. Among all the diabetic patients, type 2 diabetes accounted for 98.55% (n = 1696). Most of the patients were readmitted due to poor glycemic control, infection, edema, dizziness, and weakness, accounting for approximately 56%. During the 5-year period, the majority of readmitted diabetic patients were hospitalized twice. Times of hospitalisation was weakly positively correlated with age (Rho = 0.206, P≤0.001), diabetic duration (Rho = 0.248, P ≤ 0.001) and hospitalisation expenses (Rho = 0.008, P = 0.035) by Spearman correlation analysis. Age, duration of diabetes, systolic blood pressure (SBP), diastolic blood pressure (DBP) and alanine aminotransferase (ALT) were the main factors affecting times of hospitalisation in diabetes patients (all P < 0.05). Compared with current smokers, non-smokers and cessation smokers had high hospitalisations rate (all P for trend < 0.05). When taking diabetic foot infection as a reference, edema was more accountable than diabetic foot infection for hospitalisation times, which was statistically significant (P for trend = 0.048).Conclusion: Age, duration of diabetes and hospitalisation costs were positively correlated with times of hospitalisation. Age, duration of diabetes, blood pressure, ALT, smoking status and edema are the influencing factors of hospitalisation times. The most common causes of hospitalisation for diabetics are poor glycemic control, infection, edema, dizziness, and weakness. Controlling these factors may be key to developing rational health strategies for rural diabetics.

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Achievements of Diabetes Goals and Their Determinants in Type 2 Diabetic Patients Attending Outpatient Diabetic Clinic in Northern Ethiopia

International Journal of Chronic Diseases ◽

10.1155/2017/5713187 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Ezra Belay ◽

Abel Abera ◽

Aman Mehari ◽

Gidey Gebremeskel ◽

Asrat Endrias ◽

...

Keyword(s):

Blood Pressure ◽

Glycemic Control ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Duration Of Diabetes ◽

Type 2 Diabetic

Background. The aim of this study was to assess target diabetic goal achievements and to explore variables associated with them. Methods. A cross-sectional study was conducted between December 2015 and April 2016 on 188 type 2 diabetic patients attending Ayder Referral Hospital’s outpatient diabetic clinic. Glycemic control was assessed using fasting plasma glucose values and total cholesterol and triglyceride were used to evaluate lipid profiles. Bivariate and multivariate logistic regression analyses were done to identify factors associated with poor glycemic control, hypertension, and dyslipidemia. Result. Mean duration of diabetes was 6.5 years. Combined glycemic, lipid, and blood pressure targets were achieved only in 8.5% of the participants. More males achieved combined targets than females. Separately, while above two-thirds of the patients had poor glycemic control (67%), more than half of the participants have had poor lipid (58.5%) and blood pressure (52.1%) control. A significant portion of the patients (68.1%) had also comorbidities other than hyperglycemia. In bivariate and multivariate analyses, longer duration of diabetes disease (AOR: 3.4; P=0.013) and marked month to month fasting plasma glucose (FPG) variability as measured by large standard deviation (AOR: 2.5; P=0.023) were significantly associated with overall poor mean FPG results. Female sex was also significantly associated with dyslipidemia (AOR: 1.9; P=0.049). Conclusion. The study showed that achievements of combined diabetic goals are generally poor.

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Systemic association of newly diagnosed proliferative diabetic retinopathy among type 2 diabetes patients presented at a tertiary eye hospital of Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i1.13163 ◽

2015 ◽

Vol 7 (1) ◽

pp. 26-32

Author(s):

R Thapa ◽

S Bajimaya ◽

S Sharma ◽

B B Rai ◽

G Paudyal

Keyword(s):

Diabetic Retinopathy ◽

Glycemic Control ◽

Blood Sugar ◽

Proliferative Diabetic Retinopathy ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Newly Diagnosed ◽

Duration Of Diabetes ◽

Case Series Study

Introduction: Proliferative diabetic retinopathy (PDR) is the leading cause of blindness among the diabetics. Objective: to study the systemic association of proliferative diabetic retinopathy. Materials and methods: A prospective, case-series study was conducted among the newly diagnosed proliferative diabetic retinopathy cases presenting at the Tilganga Institute of Ophthalmology (TIO) from January 2012 to January 2013. Diabetic retinopathy was classi¿ed using the Early Treatment Diabetic Retinopathy Study criteria. Blood pressure, fasting and postprandial blood sugar, glycosylated hemoglobin, lipid pro¿le, urine for microalbumin, urea, and creatinine were evaluated at the time of diagnosis.Results: A total of 104 type 2 diabetic patients with newly diagnosed PDR presented during the study period. Concurrent macular edema was present in 93 cases (89.42 %). The mean age was 56.96 ± 9.394 (range 32 - 78) years. Males and females comprised of 75.7 % and 24.3 % respectively. The majority (37.5 %) were involved in business, followed by government service (17.30 %), and housewives (16.34 %). Mean duration of diabetes was 11.42 ± 5.356 years (range 1 month - 26 years). Concurrent hypertension was found in 55.76 %, uncontrolled fasting and or postprandial blood sugar in 72.54 %, poor glycemic control (HbA1C > 7 %) in 73.97 %, abnormal lipid profile in 52.56 %, microalbuminuria in 67.85 %, and positive urine albumin in 50 % of the cases.Conclusion: Despite the short duration of diabetes, the concurrent hypertension, poor glycemic control, proteinuria and dyslipidemia were the main systemic associations for PDR at our clinical set-up. Awareness, identification and management of these systemic problems could reduce the rapid progression to PDR.

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Clinical Profile of Patients with Diabetic Foot Ulcer Treated Conservatively or Surgically and Effect of Risk Factors on Ulcer Healing

International Journal of Research and Review ◽

10.52403/ijrr.20210629 ◽

2021 ◽

Vol 8 (6) ◽

pp. 238-244

Author(s):

Ved Prakash

Keyword(s):

Risk Factors ◽

Peripheral Neuropathy ◽

Glycemic Control ◽

Ulcer Healing ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Clinical Profile ◽

Diabetic Patients ◽

Duration Of Diabetes

Objective: The aim of this study was to assess the clinical profile of patients with diabetic foot ulcer treated conservatively or surgically and effect of risk factors on ulcer healing. Methods: This was a retrospective observational study conducted in tertiary medical teaching hospital where medical records of diabetic patients who were admitted with foot problem were evaluated. All diabetic patients who were aged >18 years and admitted with DFU were included in this study. A structured proforma was used to collect data from the medical record. SPSS version 20.0 was used to perform the statistical analysis. Result: 280 subjects with diabetic foot ulcer (DFU) were evaluated in this study. 71% ulcers were healed where as 11% were persisted unhealed. Patients who were undergone for amputation 12% were minor (Foot only) and 4% were major (above the ankle). A statistically significant association between age, duration of diabetes, glycemic control peripheral neuropathy, and ulcer size were found with diabetic foot ulcer healing. Conclusion: Modifiable factors like good glycemic control, early management of ulcers and early treatment of peripheral neuropathy can influence Diabetic foot ulcer outcomes. Special care should be provided to diabetic subjects who are aged and have longer duration of diabetes. Keywords: Diabetic foot ulcers, ulcer severity, clinical profile, Wagner’s Classification, outcome.

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Risk factors of amputation in diabetic foot infections

International Surgery Journal ◽

10.18203/2349-2902.isj20181118 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1399 ◽

Cited By ~ 1

Author(s):

Quraysh Shabbir Sadriwala ◽

Bapuji S. Gedam ◽

Murtaza A. Akhtar

Keyword(s):

Risk Factors ◽

Peripheral Neuropathy ◽

Glycemic Control ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Factors Associated ◽

Diabetic Foot Infections

Background: Diabetes is the most common underlying cause of foot ulcers, infection, and ischemia, leading to hospitalization and the most frequent cause of non-traumatic lower extremity amputation. Despite well-defined risk factors for diabetic foot ulcer development, limited data are available as to which factors predict amputation in a diabetic foot ulcer episode. Therefore, to predict lower limb amputation occurrence and to determine the factors associated with the risk of amputation in diabetic patients, we conducted this study.Methods: A hospital based longitudinal study was carried out to assess the risk factors associated with amputation in diabetic foot infection. Patients with foot infections, who were either a diagnosed case of diabetes mellitus or were diagnosed at the institute were included in the study. We excluded patients receiving immunosuppressive therapy or radiotherapy, and infections at or above the ankle joint. Study factors were demographic details, biochemical parameters, Wagner grading, peripheral neuropathy as evaluated by nerve conduction test and vasculopathy as assessed by Ankle brachial index. The primary outcome factor was amputation. The data was presented as descriptive statistics and analyzed by dividing the patients into amputation and non-amputation group, and univariate and multivariate analysis was done.Results: A total of 64 patients were included in the study, out of which the amputation rate was 39.1%. Poor glycemic control, osteomyelitis, vasculopathy, peripheral neuropathy and Wagner grading were statistically significant.Conclusions: In the present study, poor glycemic control, vasculopathy, peripheral neuropathy and higher Wagner grade are significant risk factors for amputation in diabetic foot infections.

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Pattern and Risk Factors of Diabetic Retinopathy among Type 2 Diabetic Patients: Experience in a Tertiary Care Hospital

Journal of Medicine ◽

10.3329/jom.v17i1.30053 ◽

2016 ◽

Vol 17 (1) ◽

pp. 17-20

Author(s):

Md Mostarshid Billah ◽

Muhammad Abdur Rahim ◽

Md Anisur Rahman ◽

Palash Mitra ◽

Tufayel Ahmed Chowdhury ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Retinopathy ◽

Glycemic Control ◽

Proliferative Diabetic Retinopathy ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Care Hospital ◽

Duration Of Diabetes ◽

Type 2 Diabetic

Background: Diabetic retinopathy is the commonest cause of blindness in the working age group of both developed and developing countries. It is the indicator of all micro-vascular complications of diabetes mellitus. This study was aimed to find out the frequency and pattern of diabetic retinopathy among hospitalized adult type 2 diabetic patients.Methodology: This cross-sectional study was carried out in the Department of Medicine and Endocrinology of BIRDEM General Hospital, Dhaka over a period of six months. Retinopathy was determined by fundoscopic examination in dilated pupil. Data were collected in preformed questionnaire including demographic characteristics, fundoscopic findings, and laboratory investigation reports with prior informed consent of the patients.Results: Total patients were 94, male were 52 and female were 42. Mean age of the patients was 52.2 ± 11.12 years. Hypertension was the most common (42.8%) co-morbid condition followed by dyslipidemia (33%), nephropathy (34%), neuropathy (21.3%), ischemic heart disease (9.6%) and stroke (5.3%). Study showed 37.23% Patient had good glycemic control (HbA1C <7%) and 62.77% had poor glycemic control. The frequency of retinopathy of any form was present in 36.2% patients. Among them, non-proliferative diabetic retinopathy (NPDR) was present in 78.79%, proliferative diabetic retinopathy (PDR) 6.06%, maculopathy 6.06%, both maculopathy and PDR in 9.09% diabetic patients. Among NPDR, 46.15 % was mild, 26.92% was moderate and 26.92% was severe NPDR. This study also revealed retinopathy was more with increase in duration of diabetes (66.6% vs. 17.3% p=0.01), in poorly controlled diabetic than good control (52.54% vs. 8.5%, p=0.01), those with hypertension (55% vs. 22%, p=0.02), and those having diabetic nephropathy (78.12% vs. 14.51%, p=0.01).Conclusion: This study showed frequency of diabetic retinopathy was 36.2% and among retinopathy NPDR was predominate. Poor glycemic control, increase duration of diabetes, presence of other microvascular complication i.e. nephropathy found to be significant risk factors for developing retinopathy.J MEDICINE January 2016; 17 (1) : 17-20

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Risk of Complications With the Total Contact Cast in Diabetic Foot Disorders

Foot & Ankle Specialist ◽

10.1177/1938640019895920 ◽

2019 ◽

pp. 193864001989592

Author(s):

Alexandria Riopelle ◽

Ryan LeDuc ◽

Michael Wesolowski ◽

Adam P. Schiff ◽

Michael S. Pinzur

Keyword(s):

Glycemic Control ◽

Diabetic Foot ◽

Retrospective Chart Review ◽

Poor Glycemic Control ◽

Morbidly Obese ◽

Diabetic Patients ◽

Good Glycemic Control ◽

Orthopaedic Practice ◽

Total Contact Cast ◽

Foot Morbidity

The custom-fabricated total contact cast is commonly used in the treatment of diabetic foot disorders. This resource-consuming treatment option has been associated with iatrogenic morbidity as well as the need for urgent cast removal and inspection of the underlying limb when potential problems arise. Over a 10-year period, 381 diabetic patients had 2265 total contact cast applications by certified orthopaedic technologists, in a university orthopaedic practice, under the supervision of university faculty. Patients were stratified by glycemic control based on hemoglobin A1c levels, and obesity based on body mass index (BMI). Complications were grouped as (1) development of a new ulcer or wound, (2) new or increasing odor or drainage, (3) wound infection, (4) gangrene, (5) newly identified osteomyelitis, and (6) pain or discomfort necessitating cast change or removal. At least 1 complication was observed in 159 of 381 patients. The odds of experiencing a cast-related event for patients with a BMI greater than 30 kg/m2 was 1.55 times greater than patients with a BMI less than 25 kg/m2. As compared to patients with good glycemic control, the odds of experiencing a cast-associated complication was 1.27 times greater in patients with moderate glycemic control and 1.48 times greater in patients with poor glycemic control. The total contact cast is commonly used in the treatment of diabetic foot morbidity. Treatment-associated morbidity may well be greater than previously appreciated. Complications are more likely in patients who have poor glycemic control and are morbidly obese. This information will hopefully stimulate interest in developing commercially available nonrigid alternatives that retain the attributes of the resource-consuming rigid device, with the potential advantage of avoiding the associated morbidity. Levels of Evidence: Level IV, retrospective chart review

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Magnitude and predictors of poor glycemic control among patients with diabetes attending public hospitals of Western Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0247634 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247634

Author(s):

Adugna Oluma ◽

Muktar Abadiga ◽

Getu Mosisa ◽

Werku Etafa

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Diabetes Complications ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Duration Of Diabetes ◽

Blood Glucose Test ◽

Patients With Diabetes ◽

Glucose Test ◽

Western Ethiopia

Background Diabetes is one of the most prevalent non-communicable diseases globally, which rapidly is increasing in developing countries. Ethiopia is also facing growing morbidity and mortality related to diabetes complications. Thus, dealing with glycemic control is essential for controlling the development of devastating acute and chronic complications related to diabetes. Therefore, this study aims to assess the magnitude and predictors of poor glycemic control among diabetic patients in western Ethiopia. Methods The cross-sectional study design was employed on a sample of 423 diabetic patients. A systematic random sampling method was employed. An interviewer-administered structured questionnaire was used. The data entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p-<0.25 in bivariate were entered into multivariate analysis. The multivariable logistic regressions were used to determine predictors’ poor glycemic control by considering the Adjusted Odds Ratio at CI 95% and the significance level was set at p <0.05. Results The magnitude of poor glycemic control was 64.1%. Being females (AOR = 1.684,95%CI = 1.066,2.662), duration of diabetes >8years (AOR = 2.552,95%CI = 1.397, 4.665), presence of diabetes complication (AOR = 2.806,95%CI = 1.594,4.941), negligence of blood glucose test at home (AOR = 1.720, 95%CI = 1.078, 2.743), poor self-care behavior (AOR = 1.787, 95%CI = 1.083,2.959) and poor self-efficacy (AOR = 1.934, 95%CI = 1.078,3.469) were significant predictors of poor glycemic control. Conclusion The proportion of poor glycemic control was high which was nearly comparable to that reported from many countries. This could be due to factors that were significantly associated with poor glycemic control like lack of home blood glucose test, increased duration of diabetes, presence of diabetes complications, poor self-efficacy, and poor self-care behaviors. Each were significant independent predictors of poor glycemic control. Thus, we recommend patients with diabetes and health care providers enhancing self-monitoring practices, and preventing potential complications should be a priority concern to improve blood glucose levels. Further studies are also recommended to explore important factors which were not identified by the current study.

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Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

International Journal of Bioassays ◽

10.21746/ijbio.2016.05.006 ◽

2016 ◽

Vol 5 (05) ◽

pp. 4563

Author(s):

Tariq A. Zafar

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Glycated Haemoglobin ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Age Group ◽

Hba1c Test ◽

Significant Difference ◽

Tract Infections ◽

The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah. The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively. Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

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Randomized Prospective Controlled Trial of Recombinant Granulocyte Colony-Stimulating Factor as Adjunctive Therapy for Limb-Threatening Diabetic Foot Infection

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.45.4.1094-1098.2001 ◽

2001 ◽

Vol 45 (4) ◽

pp. 1094-1098 ◽

Cited By ~ 66

Author(s):

Fausto de Lalla ◽

Giampietro Pellizzer ◽

Marco Strazzabosco ◽

Zeno Martini ◽

Giovanni Du Jardin ◽

...

Keyword(s):

Diabetic Foot ◽

Adjunctive Therapy ◽

Standard Treatment ◽

Diabetic Patients ◽

Cumulative Number ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

Diabetic Foot Infection ◽

Number Of Patients ◽

Stimulating Factor

ABSTRACT Adult diabetic patients admitted to our Diabetes Center from September 1996 to January 1998 for severe, limb-threatening foot infection were consecutively enrolled in a prospective, randomized, controlled clinical study aimed at assessing the safety and efficacy of recombinant human granulocyte colony-stimulating factor (G-CSF) (lenograstim) as an adjunctive therapy for the standard treatment of diabetic foot infection. Forty patients, all of whom displayed evidence of osteomyelitis and long-standing ulcer infection, were randomized 1:1 to receive either conventional treatment (i.e., antimicrobial therapy plus local treatment) or conventional therapy plus 263 μg of G-CSF subcutaneously daily for 21 days. The empiric antibiotic treatment (a combination of ciprofloxacin plus clindamycin) was further adjusted, when necessary, according to the results of cultures and sensitivity testing. Microbiologic assessment of foot ulcers was performed by both deep-tissue biopsy and swab cultures, performed at enrollment and on days 7 and 21 thereafter. Patients were monitored for 6 months; the major endpoints (i.e., cure, improvement, failure, and amputation) were blindly assessed at weeks 3 and 9. At enrollment, both patient groups were comparable in terms of both demographic and clinical data. None of the G-CSF-treated patients experienced either local or systemic adverse effects. At the 3- and 9-week assessments, no significant differences between the two groups could be observed concerning the number of patients either cured or improved, the number of patients displaying therapeutic failure, or the species and number of microorganisms previously yielded from cultures at day 7 and day 21. Conversely, among this small series of patients the cumulative number of amputations observed after 9 weeks of treatment appeared to be lower in the G-CSF arm; in fact, only three patients (15%) in this group had required amputation, whereas nine patients (45%) in the other group had required amputation (P = 0.038). In conclusion, the administration of G-CSF for 3 weeks as an adjunctive therapy for limb-threatening diabetic foot infection was associated with a lower rate of amputation within 9 weeks after the commencement of standard treatment. Further clinical studies aimed at precisely defining the role of this approach to this serious complication of diabetes mellitus appear to be justified.

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A Pilot Study Investigating the effect of Glycemic Control on Electrodiagnostic Parameters in Type II Diabetic Patients

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i32b31756 ◽

2021 ◽

pp. 146-153

Author(s):

Parikshit Ashok Muley ◽

Dalia A. Biswas ◽

Avinash Taksande

Keyword(s):

Risk Factor ◽

Pilot Study ◽

Glycemic Control ◽

Glycaemic Control ◽

Independent Risk Factor ◽

Diabetic Patients ◽

Type Ii ◽

Duration Of Diabetes ◽

Group Number

Background: Diabetes is a chronic metabolic abnormality due to either decreased secretion of insulin or decreased tissue sensitivity of insulin resulting in elevated blood glucose. Most common complication of diabetes is peripheral neuropathy. In this research project, we will be conducting a pilot study to observe the effect of glycaemic control on physiological functioning of nerve with the help of neurophysiological parameters, independent of duration of diabetes. Objectives: To investigate relationship of quality of glycemic control & severity of neurological changes. To find out whether glycemic control acts as an independent risk factor for progression of diabetic neuropathy despite the duration of diabetes. To validate the HBA1C at 10 for future longitudinal study to understand the association between glycemic control & progression of neuropathy. Methodology: 60 type II diabetic patients visiting diabetic OPD (Medicine) will participate in the study. The patients will be divided in to 2 groups of Group number 1 with (30 subjects) HBA1C < 10 and Group number 2 having (30 subjects) HBA1C >10. Electrodiagnostic study will be conducted on motor (tibial nerve) and sensory (sural nerve) will be performed in Neurophysiology lab. Neurophysiological parameters data of two groups will be analysed and compared. Expected Results: The pilot study will help to find out whether glycaemic control acts as a separate risk factor for progression of diabetic neuropathy despite duration of diabetes. Conclusion: This pilot study will help to establish the association between quality of glycaemic control and severity of neurological changes. Also, this will help to validate the HBA1C at 10 for further longitudinal study to know whether poor diabetes control is an independent risk factor associated to the severity of neuropathy in type II diabetes.

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