Hypertension and Sensorimotor Peripheral Neuropathy in Type 2 Diabetes

Abstract

Background: The mechanisms responsible for the onset of sensorimotor peripheral diabetic neuropathy (SMPN) remain largely unknown. To address this issue, we studied the relationship between traditional cardiovascular risk factors, parameters of metabolic control, and the presence of SMPN in patients with type 2 diabetes of relatively short duration. Methods: Blood pressure, glycated hemoglobin, lipid profile, and the presence of micro- and macrovascular complications were assessed and monitored in 31 consecutive ambulatory patients with type 2 diabetes (age 60.7 ± 7.5 years, mean ± SD) within 10 years of diagnosis (mean diabetes duration 6.0 ± 2.3 years). Results: Clinical and neurophysiological features of SMPN were present in 10 patients (SMPN+, 32%). There were no significant differences in age, gender distribution, diabetes duration, body mass index, metabolic control, and serum cholesterol between SMPN– and SMPN+ patients. However, the prevalence of hypertension (i.e. blood pressure ≧140/90 mm Hg) was higher in SMPN+ patients (10/10 vs. 13/21, χ^{2 =} 5.13, p = 0.025). Regression analysis showed that, after correcting for age, gender, duration of diabetes, glycated hemoglobin, and cholesterol, the presence of hypertension was independently associated with SMPN (R² = 0.17, p = 0.023). Conclusions: There is a strong association between hypertension and SMPN in type 2 diabetic patients with relatively short duration of disease. This relationship is independent of other risk factors.

Risk factors and prevalence of diabetic peripheral neuropathy: A study of type 2 diabetic outpatients in Bangladesh

“…[18191621] Our figures showed a numerical higher occurrence of DPN among smokers and patients with high BP, hypercholesterolemia and potential microalbuminuric /proteinuric, but like others[1612] we could not identify them as statistically significant risk factors. This is in contrast with other reports,[212324] and may have been due to the limited sample size.…”

C332C Genotype of Glyoxalase 1 and its Association with Late Diabetic Complications

“…A possible explanation might be that in type 1 diabetes, MG mainly derives from glucose whereas in type 2, due to frequently associated hypercholesterolemia, lipids might be another important source for MG [ 14 ] . Moreover, there are other risk factors like obesity and hypertension which are mainly associated with type 2 diabetes and contribute to the pathogenesis of neuropathy [ 15 ] . Therefore, not only metabolic changes in glucose associated pathways but also elevated LDL and triglyceride levels can lead to MG accumulation in diabetics [ 14 ] , which might also explain the prevention or improvement of late diabetic complications by treating hypercholesterolemia [ 16 , 17 ] .…”

Low Peripheral Nerve Conduction Velocities and Amplitudes Are Strongly Related to Diabetic Microvascular Complications in Type 1 Diabetes

“…Some found no impact of weight, systolic and diastolic blood pressure, neuropathy duration, and plasma cholesterol or triglyceride levels (17) but also suggested that vascular factors participate in the development of neuropathy (18), whereas others reported an independent association between pulse pressure and hypertension and diabetic peripheral neuropathy in patients with type 2 diabetes (19). A prospective study of 57 patients with type 2 diabetes did not confirm these findings (20).…”