Comparative Study of Gabapentin Versus Pregabalin in Improving Sensory Nerve Function and Glycemic Variability in Type 2 Diabetes Mellitus.
DOI:
https://doi.org/10.71000/pyms5a90Keywords:
Diabetic Neuropathies, Gabapentin, Glycemic Variability, Hemoglobin A1c, Insulin Resistance, Pregabalin, Time-Restricted FeedingAbstract
Background:
Diabetic peripheral neuropathy is a common and disabling complication of type 2 diabetes mellitus, leading to sensory deficits, neuropathic pain, and higher risk of foot-related morbidity. While gabapentin and pregabalin are routinely used for symptom relief, there is limited local evidence comparing their effects on objective sensory nerve function and glycemic variability.
Objective:
To compare the effectiveness of gabapentin and pregabalin in improving sensory nerve conduction and glycemic variability among adults with type 2 diabetes mellitus and peripheral neuropathy.
Methods:
This randomized, parallel-group study was conducted at Services Hospital Lahore from August 2024 to April 2025. A total of 62 patients were enrolled and assigned equally to gabapentin or pregabalin therapy for 12 weeks. Sensory nerve conduction of sural and median nerves was assessed at baseline and week 12 using standardized EMG–NCV testing. Glycemic variability was evaluated through 72-hour continuous glucose monitoring, documenting mean amplitude of glycemic excursions, standard deviation of glucose, and time-in-range. HbA1c was measured for additional metabolic assessment. Data were analyzed using SPSS 27, applying paired and independent t-tests with significance set at p < 0.05.
Results:
Fifty-six patients completed the study. In the gabapentin group, sural conduction velocity improved from 38.4 ± 3.9 m/s to 41.6 ± 4.0 m/s, while pregabalin improved from 38.2 ± 4.1 m/s to 43.8 ± 4.5 m/s. Mean amplitude of glycemic excursions decreased from 62.3 ± 10.8 mg/dL to 56.1 ± 9.7 mg/dL in the gabapentin group and from 61.7 ± 11.0 mg/dL to 52.5 ± 9.1 mg/dL with pregabalin. All changes were statistically significant within groups. No serious adverse effects were observed.
Conclusion:
Both gabapentin and pregabalin significantly improved sensory nerve function and reduced glycemic variability in diabetic neuropathy. Pregabalin showed comparatively greater improvement, though gabapentin remained effective and economically accessible. These findings support the use of calcium channel modulators as functional therapeutic options beyond symptomatic pain relief in diabetic neuropathy.
Keywords:
Diabetic Neuropathies, Gabapentin, Glycemic Variability, Hemoglobin A1c, Insulin Resistance, Pregabalin, Time-Restricted Feeding
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Copyright (c) 2025 Farah Nadia Sheikh, Rizwana Riaz (Author)
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