Diabetic peripheral neuropathy in the outpatient department – a red-flag for associated risk factors and comorbidities

Abstract

Objectives. To assess the characteristics of patients with type 2 diabetes mellitus (DM) and diabetic peripheral neuropathy (DPN) as compared to patients with type 2 DM without DPN in an ambulatory setting, given the pandemic size of DM and its challenge for the healthcare systems worldwide in the 21st century. From the chronic complications of DM, DPN has a major impact on the patient’s life quality. DPN risk factors are both modifiable and unmodifiable and represent either other comorbidities per se, or predisposing factors for various comorbidities that alter the patient’s prognosis. Material and Methods. We conducted a retrospective observational study with 112 patients with type 2 DM treated in an out-patient department, in order to assess the characteristics and associated comorbidities of DPN. The group characteristics are a mean age of 60.28±9.76 years; 62.5% males; 77.67% from urban settlement; a prevalence of DPN of 52.67%. Outcomes. In the statistical analysis, DPN significantly associated with duration of DM, the need for insulin-therapy, risk factors such as smoking or obesity; with other complications of DM such as retinopathy, chronic kidney disease, atherosclerotic cardiovascular disease or peripheral artery disease; with comorbidities such as heart failure; and with the level of HDL-cholesterol and eGFR. Conclusions. A patient with DPN is more prone to also present other microvascular complications of type 2 DM, such as chronic kidney disease, retinopathy and, respectively with macrovascular complications of type 2 DM, and with other comorbidities such as heart failure and obesity. Its easily available diagnosis in an ambulatory setting by quantitative sensory testing should offer to DPN the status of a good marker for the presence of other chronic complications or comorbidities in type 2 DM, prompting the patient’s screening and an adequate medical management.