Evaluation of Factors Associated with Diabetic Peripheral Neuropathy in Patients with Diabetes

Abstract

Introduction: Diabetic peripheral neuropathy is an important long-term and ignored complication of diabetes. The presence of diabetic polyneuropathy (DPN) causes serious morbidities, especially recurrent lower extremity infections, ulcerations and subsequent amputations, and early diagnosis is important. Our study aimed to examine the factors associated with DPN and to emphasize that morbidity can be prevented with early and rapid diagnosis of neuropathy. Material Method: Diabetic Neuropathic Pain Questionnaire (Douler Neuropathic 4 Questions DN-4) was administered to patients diagnosed with Diabetes Mellitus (DM). Additionally, touch hypoesthesia, needle hypoesthesia, and pain to touch in the extremity were examined. The demographic characteristics of the patients were questioned and recorded. Data obtained from routine laboratory results were recorded. Results: 60 female (57.7%) and 44 (42.3%) male patients were included in the study. Diabetic Neuropathy was detected in 56 (53.8%) of the patients included in the study. A high correlation was detected between DN-4 score and HbA1c and Diabetes Year (r=0.791, p< 0.001, r =0.692, p< 0.001 respectively). A weak correlation was detected between DN-4 score and LDL cholesterol triglyceride level (r= 0.124, p=0.364, r=0.183, p=0.176, respectively). When patients with Diabetic Neuropathy were classified according to the DN-4 Score, no difference was found between the two groups based on gender (p = 0.383). In our study, 62 years of age was determined as the cut-off point for DPN (p<0.001). Accordingly, patient age over 62 years is the cut-off point for DPN. This shows that the risk of DPN increases with advanced age. In addition, HbA1c over 7.6 was found to be significant for the diagnosis of DPN and a history of diabetes of 6 years or more was found to be significant for the development of DPN (p<0.001). Conclusion: According to our study, the risk of DPN increases with high HbA1c, advanced age, and increased duration of diabetes. Our study is important in terms of demonstrating the feasibility of screening tests in outpatient clinics and raising awareness.

Keywords

• Diabetes mellitus
• Diabetic peripheral neuropathy
• HbA1c
• Diabetic neuropathic pain questionnaire

Diyabetli Hastalarda Diyabetik Periferal Nöropati ile İlişkili Faktörlerin Değerlendirilmesi

Abstract

Giriş: Diyabetik periferal nöropati, diyabetin uzun sürede görülen ve göz ardı edilen önemli bir komplikasyonudur. Diyabetik polinöropatinin (DPN) varlığı, tekrarlayan alt ekstremite enfeksiyonları, ülserasyonlar ve takip eden ampütasyonlar başta olmak üzere ciddi morbiditelere yol açar ve erken tanınması önem taşımaktadır. Çalışmamızda DPN ile ilişkili faktörlerin irdelenmesi ve nöropatide hızlı tanı testiyle erken ve hızlı teşhisin önemi vurgulanmaya çalışılmıştır. Materyal Metod: Diyabetes Mellitus (DM) tanılı hastalara Diyabetik Nöropatik Ağrı Anketi (Douler Neuropathique 4 Questions DN-4) yapıldı. Ayrıca dokunma hipoestezisi iğne hipoestezizi ve extremitede dokunma ile ağrı olup olmadığı muayene edildi. Hastaların demografik özellikleri sorgulanıp kayıt edildi. Rutin labaratuar sonuçlarından elde edilen veriler kayıt altına alındı. Bulgular: Çalışmaya 60 kadın (%57.7) 44 (%42.3) erkek hasta alındı. Çalışmaya alınan hastaların 56’sında (%53.8) Diyabetik Nöropati saptandı. DN-4 skoru ile HbA1c ve Diyabet yıl arasında yüksek korelasyon saptandı (sırasıyla r=0.791, p< 0.001, r =0.692, p< 0.001 ). DN-4 skoru LDL kolesterol trigliserid düzeyi arasında zayıf korelasyon saptandı (sırasıyla r= 0.124, p=0.364, r=0.183, p=0.176). DN-4 Skoruna göre Diyabetik Nöropati olan hastalar sınıflandırıldığında cinsiyete bağlı her iki grup arasında farklılık saptanmadı (p=0.383). Çalışmamızda 62 yaş DPN için kesim noktası değeri olarak saptandı (p<0.001). Buna göre hasta yaşının 62 yıl üstü olması DPN için kesim noktası değeridir. Bu ileri yaş ile DPN riskininin arttığını göstermektedir. Ayrıca HbA1c 7,6 üzeri olması DPN tanısı için ve 6 yıl ve üzeri diyabet geçmişi olması DPN gelişmesi için anlamlı olarak saptandı (p<0.001). Sonuç: Çalışmamıza göre yüksek HbA1c, ileri yaş ve diyabet süresinin artmasıyla DPN riski artış göstermektedir. Çalışmamız tarama testlerinin poliklinik şartlarında yapılabilirliğini göstermesi ve farkındalık oluşturması açısından önemlidir.

Keywords

• Diyabetes mellitus
• Diyabetik periferal nöropati
• HbA1c
• Diyabetik nöropatik ağrı anketi

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