Association between Diabetic Polyneuropathy and Cardiovascular Complications in Type 2 Diabetic Patients

Wang

et al. 2015

Acta Ophthalmologica

ABSTRACT.Purpose: To assess the relationship between diabetic polyneuropathy (DPN) and the risk of diabetic retinopathy (DR). Methods: From 1997 to 2010, we identified 5031 newly diagnosed DPN patients and 20 124 controls matched for sex, age, and index year. Cox proportional hazards regression analyses were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of DR between the DPN patients and the non-DPN group. The adjusted hazard ratio was calculated and adjusted for age, sex, duration of diabetes and comorbidities of hypertension, cardiovascular disease and diabetic nephropathy. Results: The incidence rate of DR was 5.87-fold higher in the DPN patients than in the non-DPN group (44.0 vs. 7.22 per 1000 person-years), with an adjusted HR of 5.41(95% CI = 4.92-5.94). The DPN-to-non-DPN DR incidence rate ratio decreased with age (adjusted HR = 6.63 for subgroup younger than 65 years and adjusted HR = 3.91 for subgroup aged 65 years or older). Compared with the non-DPN group, the DPN patients had a 5.63-fold risk of non-proliferative DR (adjusted HR = 5.63, 95% CI = 5.11-6.21) and a 3.67-fold risk of proliferative DR (adjusted HR = 3.67, 95% CI = 2.57-5.23). Conclusion: The patients with DPN had an increased risk of developing DR and advanced DR compared with the non-DPN group, particularly among the subgroup aged younger than 65 years.

Section: Discussionmentioning

confidence: 67%

“…; Chung et al. ). However, a relationship between DPN and diabetic nephropathy has not been consistently demonstrated.…”

Section: Discussionmentioning

confidence: 96%

Diabetic polyneuropathy and the risk of developing diabetic retinopathy: a nationwide, population‐based study

Wang

et al. 2015

Acta Ophthalmologica

European Journal of Cardiovascular Nursing

“…Hence, direct and straight comparisons will have to wait for the time being. Interestingly, some prospective works have proven a relationship between cardiovascular risk factors and distal symmetrical DPN development in type 1 15,22,23 and in type 2 diabetes mellitus 16,24,25 . Noteworthy, CVD at baseline was associated with double risk of neuropathy independently of cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…While the relationship between cardiac autonomic neuropathy and sudden death from CVD is demonstrated, 14 the evidence on the relationship between DPN and CVD has focused primarily on identifying its relationship with cardiovascular risk factors, 15 especially by cross-sectional studies. 16 Conversely, a recent publication has reported previous DPN being associated with a higher risk of presenting a first cardiovascular event. 17 To the best of our knowledge, there are no prospective studies focusing on the relationship between CVD presence and DPN development in T2DM patients.…”

Section: Introductionmentioning

confidence: 98%

Cardiovascular disease predicts diabetic peripheral polyneuropathy in subjects with type 2 diabetes: A 10-year prospective study

Ybarra-Muñoz

Jurado-Campos

García-Gil

et al. 2014

Background:The relationship between cardiovascular disease and diabetic peripheral neuropathy is mainly sustained by data retrieved from cross-sectional studies focused on cardiovascular risk factors. We aimed to assess the presence of cardiovascular disease as a risk factor for developing diabetic peripheral neuropathy in a type 2 diabetes mellitus population. Method: A 10-year prospective, primary care, multicentre study in a randomly selected cohort. Cardiovascular disease presence included stroke, coronary artery disease and/or peripheral ischaemia. Diabetic peripheral neuropathy diagnosis was based on clinical neurological examination as well as the neuropathy symptoms score and nerve conduction studies. Results: Three hundred and ten (N=310) patients were initially recruited. Two-hundred and sixty seven (N=267) patients were included in the study. Diabetic peripheral neuropathy cumulative incidence was 18.3% (95% confidence intervals 14.1-23.4; N=49). Diabetic peripheral neuropathy development was significantly more frequent in participants presenting with cardiovascular disease at baseline (P=0.01). In the final logistic regression analysis, the presence of cardiovascular disease remained associated with an increased risk for diabetic peripheral neuropathy (odds ratio 2.32, 95% confidence intervals 1.03-5.22) in addition to diabetes duration and low density lipoprotein-cholesterol levels. Conclusions: In our series, type 2 diabetes mellitus patients with cardiovascular disease at baseline present with an increased risk of developing diabetic peripheral neuropathy at 10 years of follow-up. Our results suggest that measures aimed at the prevention, control and treatment of cardiovascular disease can also help prevent diabetic peripheral neuropathy development.

Journal of Global Health Reports

“…Nevertheless, glycemic control is still an important aspect of type 2 diabetes control, as poor glucose control contributes to increased complication rates, and complications from neuropathy (ie, foot ulcers and deformities) are exacerbated by poor glucose control. 30 Therefore, glycemic control can be a major area healthcare workers can focus on in clinical practice to improve outcomes of type 2 diabetes in LMICs such as Peru.…”

Section: Other Relevant Resultsmentioning

confidence: 99%

Characterizing distal peripheral neuropathy in type 2 diabetes mellitus in a semi-urban community setting in Peru

Iyengar

Bernabé‐Ortiz

2019

Back Background ground Distal peripheral neuropathy (DPN) is a devastating complication of type 2 diabetes that is causing medical and economic burden worldwide, especially in developing nations like Peru. Hospital prevalence of DPN has been determined in Peru, but information characterizing DPN in the community is scarce. This study characterized DPN among individuals with Type 2 diabetes using a population-based survey in Peru. Methods Methods Cross-sectional, population-based study conducted in Tumbes, Peru. Participants were categorized by glycemic status measured by an oral glucose tolerance test. Neuropathic status was measured by biothesiometry. R Result esult A total of 1,607 participants were included, mean age 48.2 (standard deviation (SD)=0.3), and 810 (50.3%) women. A total of 176 (11.0%, 95% confidence interval (CI)=9.5-12.6%) persons had type 2 diabetes and 272 (17%; 95% CI=15.1-18.8%) had dysglycemia. Among those with type 2 diabetes, 105 (59.7%) were aware of their diagnosis, with 94 (89.5%) on treatment, and only 30 (28.6%) with appropriate control. DPN prevalence was 44.3% among those with type 2 diabetes and 19.8% among those with dysglycemia. In multivariable model, type 2 diabetes, but not dysglycemia, was associated with a 1.28-increased (95% CI=1.13-1.45) prevalence of DPN compared to normal controls. C Conclusions onclusions There is a high prevalence of DPN at community level. The high prevalence of DPN and high amount of undiagnosed and uncontrolled cases of type 2 diabetes demonstrate a need for earlier detection, stricter glycemic control, and improved screening, especially in resource-constrained settings like Peru.