Association of Non-Dipping Blood Pressure Patterns with Diabetic Peripheral Neuropathy: A Cross-Sectional Study among a Population with Diabetes in Greece

Abstract

Diabetic peripheral neuropathy (DPN) is present in 20–50% of cases with diabetes. The pathophysiology of DPN is not yet clear regarding hypertension (HTN). The aim of this study was to assess the association between the stages of DPN and HTN in a Greek population with diabetes. We examined 102 adults for diabetic neuropathy (DPN) from November 2020 to December 2021, using the Toronto Clinical Neuropathy Scale System (TCNSS) to categorize them into two groups (no/mild DPN versus medium/severe DPN). Ambulatory blood pressure monitoring was performed to evaluate their hypertensive status. Univariate and multivariate logistic regression analyses were performed to assess the association between the stage of DPN and HTN. The multivariate analysis, considering sex, age, and dipping status, did not show statistically significant associations between stages of HTN and DPN. However, in contrast to dippers, non-dippers had an almost four-times higher risk of developing medium-to-severe DPN (odds ratio (OR) 3.93; 95% confidence interval (CI) [1.33–11.64]); females, in contrast to males, had a 65% lower risk of developing moderate/severe DPN (OR 0.35; 95%CI [0.14–0.92]). In conclusion, our findings showed no statistically significant associations between DPN and HTN; however, dipping status, hyperglycemia, and female sex were shown to play a role in the pathophysiology of DPN.

While You Are Sleeping: Marital Ambivalence and Blunted Nocturnal Blood Pressure

“…It has been linked to higher risk of cardiovascular disease, reduced kidney function, high renal risk, poorer renal outcomes, as well as greater kidney disease progression in patients with chronic kidney disease [ 51 , 52 , 53 , 54 , 55 ]. Blunted dipping is also associated with increased risk of all-cause mortality and composite kidney endpoint for people with type 1 diabetes [ 56 ], while blunted dipping is associated with diabetic peripheral neuropathy [ 57 ]. Further, blunted dipping was associated with incidence of diabetes in a 21-year follow up [ 58 ].…”