Clinical and electrophysiological correlations in type 2 diabetes mellitus at diagnosis

Rota, Eugenia; Quadri, R.; Fanti, Edoardo; Poglio, Fabio; Paolasso, Ilaria; Ciaramitaro, P.; Cossa, Federico M.; Cocito, Dario

doi:10.1016/j.diabres.2006.07.027

Cited by 13 publications

(7 citation statements)

References 12 publications

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“…Moreover, our results demonstrated that parasympathetic nerve activity was more commonly and severely impaired than sympathetic nerve activity in this population. Eugenia Rota [ 22 ] found that the E/I test is abnormal in 28% of newly-diagnosed type 2 diabetic patients, and postural hypotension is present in 6% of that population, similar to our findings. However, sympathetic dysfunction (51.9%) has been found to be slightly more common than parasympathetic dysfunction (44.2%) in an Indian population with a relatively longer duration of diabetes [ 23 ].…”

Section: Discussionsupporting

confidence: 91%

Decreased β-Cell Function is Associated with Cardiovascular Autonomic Neuropathy in Chinese Patients Newly Diagnosed with Type 2 Diabetes

Yang

Zhu

et al. 2018

Neurosci. Bull.

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The influence of β-cell function on cardiovascular autonomic neuropathy (CAN), an important diabetes-related complication, is still unclear. In this study, we aimed to investigate the association between residual β-cell function and CAN in patients newly diagnosed with type 2 diabetes. We enrolled 90 newly-diagnosed type 2 diabetic patients and 37 participants with normal glucose tolerance as controls. The patients were divided into a CAN+ group (diabetic patients with CAN, n = 20) and a CAN− group (diabetic patients without CAN, n = 70) according to the standard Ewing battery of tests. Fasting and postprandial plasma glucose, insulin, and C-peptide were measured. Homeostasis model assessment-beta cells (HOMA-B) and HOMA-insulin resistance (IR) were calculated. The prevalence of CAN in this population was 22.2%. Compared with the CAN− group, the CAN+ group had significantly lower fasting plasma insulin (6.60 ± 4.39 vs 10.45 ± 7.82 μ/L, P = 0.029), fasting C-peptide (0.51 ± 0.20 vs 0.82 ± 0.51 nmol/L, P = 0.004), and HOMA-B (21.44 ± 17.06 vs 44.17 ± 38.49, P = 0.002). Fasting C-peptide was correlated with the Valsalva ratio (r = 0.24, P = 0.043) and the 30:15 test (r = 0.26, P = 0.023). Further analysis showed that fasting C-peptide (OR: 0.041, 95% CI 0.003–0.501, P = 0.012) and HOMA-B (OR: 0.965, 95% CI 0.934–0.996, P = 0.028) were independently associated with cardiovascular autonomic nerve function in this population. The patients with fasting C-peptide values < 0.67 nmol/L were more likely to have CAN than those with C-peptide levels ≥0.67 nmol/L (OR: 6.00, 95% CI 1.815–19.830, P = 0.003). A high prevalence of CAN was found in patients with newly-diagnosed type 2 diabetes. Decreased β-cell function was closely associated with CAN in this population.

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Section: Discussionsupporting

confidence: 91%

Decreased β-Cell Function is Associated with Cardiovascular Autonomic Neuropathy in Chinese Patients Newly Diagnosed with Type 2 Diabetes

Yang

Zhu

et al. 2018

Neurosci. Bull.

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“…Glucose and lipids are involved in the pathway and subsequent osmotic stress, electron transport overload, and formation of reactive oxygen species, with the result of DNA damage and cell apoptosis [22]. In a previous study, newly diagnosed persons with type 2 DM had a high prevalence of diabetic neuropathy, as much as 60% when measured by NCS and 39% when measured by a vibration threshold test [23]. The abnormality of each ; HTN: hypertension; Hom: homocysteine; T-CHOL: total cholesterol; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; TG: triglyceride; eGFR: estimated glomerular filtration rate.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Distal Symmetrical Polyneuropathy: Correlation of Clinical, Laboratory, and Electrophysiologic Studies in Patients with Type 2 Diabetes Mellitus

Weng

Tsai

Lyu

et al. 2020

Journal of Diabetes Research

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This cross-sectional study is aimed at determining the prevalence of distal symmetrical polyneuropathy (DSPN) and diabetic peripheral neuropathic pain (DPNP) in participants with type 2 diabetes mellitus (T2DM); finding the risk factors for DSPN and DPNP via biochemical tests; and correlating DSPN and DPNP with the results of electrophysiologic studies, quantitative sensory tests, and neurologic examination. The 145 participants with T2DM enrolled were divided into the DSPN (abnormal nerve conduction studies (NCS) with signs of polyneuropathy), subclinical DSPN (abnormal NCS without signs of polyneuropathy), minimal DSPN (normal NCS with signs of polyneuropathy), and no DSPN groups. The biochemical risk factors of diabetic peripheral neuropathy were investigated. Neurologic examinations, laboratory tests, NCS, vibration threshold tests, and thermal threshold tests were conducted. The modified Michigan Neuropathy Screening Instrument (mMNSI) and Douleur Neuropathique 4 were used to evaluate the severity of DSPN and DPNP, respectively. In all, 30% of participants had DSPN and 11% had DPNP. DSPN correlated strongly with male gender and higher glycohaemoglobin levels; NCS abnormality correlated with higher glycohaemoglobin levels; DSPN severity correlated with NCS of each stimulating nerve. DPNP commonly occurred with clinical and electrophysiologic evidence of DSPN. Symptomatic diabetic polyneuropathy significantly correlated with longer disease duration, higher glycohaemoglobin levels, and abnormal vibration tests. The thermal threshold test combined with nerve conduction tests could detect most of the patients with DSPN, subclinical DSPN, and minimal DSPN. Poor diabetic control was independently associated with the development of DSPN. DPNP was associated with DSPN. The combination of thermal threshold tests with NCS can potentially provide the diagnosis of DSPN.

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“…In 145 patients with recently detected type 2 diabetes, combined parasympathetic dysfunction (abnormal and borderline) was found in 44.2% of patients, whereas combined sympathetic dysfunction occurred in 51.9% (14). In 39 patients with newly diagnosed type 2 diabetes, DB was abnormal in 28% of patients, and 6% had postural hypotension (15). Considering all these disparities in estimates of autonomic dysfunction as a result of small samples, differences in tests applied, and differences in the methodology of the interpretation of tests results, our study adds important information; we evaluated a very large We found that BMI was the only significant factor associated with CAN.…”

Section: Discussionmentioning

confidence: 99%

“…Despite its prevalence and clinical impact, CAN is still widely underdiagnosed, probably because of the need for training and expertise in the performance of cardiovascular autonomic tests (10). In particular, information on the prevalence of CAN in patients with newly diagnosed type 2 diabetes is scarce and not easy to interpret because of both the different diagnostic approaches in terms of the number and types of tests performed and the differences in the diagnostic cutoff points (11)(12)(13)(14)(15). The prevalence of CAN at diagnosis of diabetes is still uncertain (16).…”

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confidence: 99%

Prevalence of Cardiovascular Autonomic Neuropathy in a Cohort of Patients With Newly Diagnosed Type 2 Diabetes: The Verona Newly Diagnosed Type 2 Diabetes Study (VNDS)

et al. 2015

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OBJECTIVECardiovascular autonomic diabetic neuropathy (CAN) is a serious complication of diabetes. No reliable data on the prevalence of CAN among patients with newly diagnosed type 2 diabetes are available. Therefore, the aim of this study was to estimate the prevalence of CAN among patients with newly diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODSA cohort of 557 patients with newly diagnosed type 2 diabetes with cardiovascular autonomic test results available was selected. Early and confirmed neuropathy were assessed using a standardized methodology and their prevalences determined. A multivariate logistic regression analysis was modeled to study the factors associated with CAN. RESULTSIn the entire cohort, the prevalence of confirmed CAN was 1.8%, whereas that of early CAN was 15.3%. Prevalence did not differ between men and women. In the multivariate analyses BMI results were independently and significantly associated with CAN after adjusting for age, sex, hemoglobin A 1c , pulse pressure, triglyceride-to-HDL cholesterol ratio, kidney function parameters, and antihypertensive treatment.

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Clinical and electrophysiological correlations in type 2 diabetes mellitus at diagnosis

Cited by 13 publications

References 12 publications

Decreased β-Cell Function is Associated with Cardiovascular Autonomic Neuropathy in Chinese Patients Newly Diagnosed with Type 2 Diabetes

Decreased β-Cell Function is Associated with Cardiovascular Autonomic Neuropathy in Chinese Patients Newly Diagnosed with Type 2 Diabetes

Diabetic Distal Symmetrical Polyneuropathy: Correlation of Clinical, Laboratory, and Electrophysiologic Studies in Patients with Type 2 Diabetes Mellitus

Prevalence of Cardiovascular Autonomic Neuropathy in a Cohort of Patients With Newly Diagnosed Type 2 Diabetes: The Verona Newly Diagnosed Type 2 Diabetes Study (VNDS)

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