Age as an independent factor for the development of neuropathy in diabetic patients

Abstract

Population aging is unprecedented, without parallel in the history of humanity. As type 2 diabetes mellitus is predominantly more prevalent in aging populations, this creates a major public health burden. Older adults with diabetes have the highest rates of major lower-extremity amputation, myocardial infarction, visual impairment, and end-stage renal disease of any age group. The aims of our study were to assess whether age is an independent factor for the occurrence of diabetic neuropathy (DN), and to evaluate the relationship between the presence and the severity of DN and the diabetes duration and blood glucose level. In this study, we enrolled 198 patients, previously diagnosed with type 2 diabetes mellitus. For all patients, we measured hemoglobin A1c (HbA1c), lipid profile, and body mass index and we assessed the presence and severity of DN using the evaluation of clinical signs and symptoms. Patients had a median age of 62 years, with a median of diabetes duration of 7 years; 55.1% of the patients were men and the average HbA1c in the cohort was 8.2%. The prevalence of DN according to Michigan Neuropathy Screening Instrument was 28.8%, being significantly and positively correlated with higher age (65 vs 59 years; P=0.001) and HbA1c (8.6% vs 8.0%; P=0.027). No significant correlations were observed between the severity of DN and diabetes duration, body mass index (31.9 vs 29.9 kg/m2), or the number of centimeters exceeding the normal waist circumference (25.2 vs 17.3 cm; P=0.003). In conclusion, age influences the presence of DN, independent on other risk factors. This influence persists even after adjusting for other, very important risk factors, like blood glucose level or diabetes duration.

Diabetic Polyneuropathy in Type 2 Diabetes Mellitus: Inflammation, Oxidative Stress, and Mitochondrial Function

“…Moreover, a quantitative assessment of nerve conduction studies in patients with type 2 DM found that increased HbA1c is a risk factor for severity of DPN, resulting in an OR of 5.233 (95% CI 1.700–16.103), p = 0.004) [54]. These findings have been constantly reported, with a more recent study associating the presence of an altered HbA1c with DPN (OR 1.139 [95% CI 1.021–1.271]) [39] and >50% of patients with DPN having HbA1c ≥ 7% [19, 43]. Another risk factor is longer diabetes duration , with adjusted OR 1.05 (95% CI 1.02–1.08) [19, 28, 39].…”

“…The temperature also influences the measures, as shown in nerve conduction studies of normal subjects, and in consequence the protocols for nerve conduction studies include having a standardized normal temperature room [49, 50]. Age is the most evaluated risk factor in the majority of epidemiological studies, with those ≥70 years old considered the most prevalent group for DPN (odds ratio [OR] 1.073 [95% CI 1.051–1.097], p < 0.001); it is considered a risk factor for symptoms, deficits, and sensation perception deficits, so much for presence and severity of DPN [17, 19, 39, 42, 43]. Disparity results are found regarding gender , with some authors reporting male sex as a severity risk factor (OR 2.01, p = 0.02) [19, 51].…”

Diabetic Neuropathy Evaluated by a Novel Device: Sural Nerve Conduction Is Associated with Glycemic Control and Ankle–Brachial Pressure Index in Japanese Patients with Diabetes

“…Aging is also an independent risk factor for the development of DN ( 31 ); however, aging was associated with a decreased risk of reduction in SNAP. Although the underlying cause is unknown, older patients with diabetes might have already suffered from progressed DN which does not change in only 1 year.…”

The efficacy of cocarnit in diabetic neuropathy

“…Дистальная симметричная сенсомоторная полинейропатия встречается, по разным данным, более чем у 20% больных СД 1-го типа (СД1) через 20 лет от дебюта заболевания и у 10-15% при вновь диагностированном СД 2-го типа (СД2), увеличиваясь до 50% через 10 лет [7]. По мнению ряда авторов, фактическая распространенность нейропатии у пациентов с диабетом составляет до 30-50% в течение заболевания [8], доходя до 90% [9][10][11].…”

“…Согласно данным проведенных исследований, среди важнейших факторов, сопряженных с развитием микрососудистых нарушений при СД2, рассматриваются возраст больного [18][19][20], повышенные показатели системного артериального давления, значения HbA 1c , глюкозы натощак (FBG) и через 2 ч после завтрака (2 hBG) [21,22], а также индекса массы тела, включая антропометрические показатели ожирения, такие как окружность талии (WC), соотношение талии к бедрам (WHR) и талии к росту (WHtR) [23]. Ряд исследователей [10] особо выделяют дислипидемию, артериальную гипертонию и курение как наиболее значимые факторы риска развития ДПН.…”