The role of hemogram parameters in predicting diabetic neuropathy risk in patients follow-up with type 2 diabetes mellitus

Aims: Neuropathy, which develops during the course of Diabetes Mellitus (DM), significantly affects patients' quality of life, making its early diagnosis and detection crucial. Furthermore, it is thought that the impact of neuropathy developing in the course of DM is not localized but has systemic effects. In our study, we will investigate the role of evaluating hemogram parameters and systemic effects in predicting the risk and monitoring the course of diabetic neuropathy in patients followed up with DM. Methods: Data from patients who presented to the xxx University Neurology outpatient clinic between 2024 and 2025 will be scanned. This will include patients diagnosed with diabetic neuropathy and Diabetes Mellitus, as well as those investigated for but not found to have neuropathy. One hundred individuals will be included in each group. Group 1 was defined as 50 individuals with a diagnosis of diabetic neuropathy, and Group 2 as 50 individuals without a diagnosis of diabetic neuropathy. Within the scope of the study, the following data will be recorded from the hospital data system: patients' age, gender, past medical histories, diagnoses, treatments received, and laboratory test results including hemogram, HbA1c, glucose, sedimentation, CRP, ALT, AST, BUN, creatinine, B12, vitamin D, folic acid, ferritin, and electrolyte levels. The ratios of neutrophil, platelet, and monocyte counts to lymphocytes will be calculated and analyzed to assess their association with neuropathy. The data will be analyzed using SPSS, with the significance level set at 0.005. Results: Of the 100 individuals included in the study, 61 (55.5%) were female and 39 (35.5%) were male; the mean age was calculated as 45.77 ± 17.48. The 50 individuals with diabetic polyneuropathy and the 50 individuals in the healthy control group were analyzed as two groups. Among the 100 patient individuals, 44 (48.9%) were within the target HbA1c range, while 46 (51.1%) individuals were observed to have uncontrolled DM. No statistically significant difference was observed between the groups in terms of fasting blood glucose and HbA1c levels (p=0.657). While no statistically significant difference was observed in NLR and PLR, calculated from the same hemogram data in Group 1 and Group 2 (p=0.647 and p=0.242, respectively), the difference in MLR was found to be statistically significant (p=0.0024). Conclusion: Although diabetic neuropathy presents with localized symptoms, its effects are systemic. The monocyte-to-lymphocyte ratio (MLR) was evaluated as a usable parameter for the early detection of developing neuropathy and for determining neuropathy risk. Its correlation with next-generation inflammatory biomarkers may be required. As hemogram data is a test that is available and feasible to perform in most medical centers, it could be a suitable tool for monitoring the development of neuropathy in DM patients, and potentially for post-treatment follow-up.