1. Trends in the relation between hyperglycemia correction and active Charcot neuroarthropathy: results from the EPICHAR study
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Maud François, Dured Dardari, Ariane Sultan, Vincent Rigalleau, Marie Müller, Agnes Hartemann, Laurence Kessler, Isabelle Dumont, Sophie Schuldiner, Carole-Anne Julien, Georges Ha Van, Jocelyne M’Bemba, Muriel Bourgeon, Marc Lepeut, Sylvie Grandperret-Vauthier, Florence Baudoux, Sylvaine Clavel, Jacques Martini, Julien Vouillarmet, Paul Michon, Myriam Moret, Arnaud Monnier, Vaneva Chingan-Martino, Ionela Stifii, Benjamin Bouillet, Pierre Bonnin, Amal Lemoine, Enrique Da Costa Correia, Marie Martine Bonello Faraill, Marie Cazaubiel, and Mohammed Zakarya Zemmache
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Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Introduction The pathophysiology of Charcot neuroarthropathy (CN) remains unclear. There are a number of hypotheses but these are not exclusive. In its clinical presentation, this complication intersects with the semiology of diabetic-induced neuropathy, such as peripheral hypervascularization and the appearance of arteriovenous shunt. The EPICHAR study is as yet an unpublished cohort of people living with diabetes complicated by CN (in active or chronic phase). Based on the findings of the EPICHAR study, this study aimed to investigate whether a reduction in the rate of hyperglycemia accompanies the onset of an active phase of CN.Research design and methods Hemoglobin A1c (HbA1c) levels were assessed 3 months (M3) and 6 months (M6) before the diagnosis of active CN (M0).Results 103 patients living with diabetes and presenting active CN were included between January and December 2019 from the 31 centers participating in this study (30 in France and 1 in Belgium). The mean age of the participants was 60.2±12.2 years; the vast majority were men (71.8%) living with type 2 diabetes (75.5%). Mean HbA1c levels significantly declined between M6 (median 7.70; Q1, Q3: 7.00, 8.55) and M3 (median 7.65; Q1, Q3: 6.90, 8.50) (p=0.012), as well as between M6 and M0 (median 7.40; Q1, Q3: 6.50, 8.50) (p=0.014). No significant difference was found between M3 and M0 (p=0.072).Conclusions A significant reduction in HbA1c levels seems to accompany the onset of the active phase of CN.Trial registration number NCM03744039.
- Published
- 2022
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