Restless Legs Syndrome Among Sudanese Patients With Type 2 Diabetes Mellitus: A Case-Control Study

Abstract

Background There is increasing awareness about the association of restless legs syndrome (RLS) with type 2 diabetes. This study assessed RLS and its associations among patients with diabetes. Material and methods This case-control study was conducted among 160 subjects (82 patients with diabetes and 78 controls) attending a diabetic clinic in Omdurman, Sudan, during the period from June 2018 to September 2019. A structured questionnaire was used to collect demographic factors, diabetic neuropathy, nephropathy, retinopathy, and macrovascular complications. The neck circumference was measured to assess adiposity, and a blood sample was taken for the glycated hemoglobin (HbA1 c) estimation. The local ethical committee approved the research, and the Statistical Package for Social Sciences (SPSS; IBM Corp., Armonk, NY) was used for data analysis. A P-value of <0.05 was considered significant. Results There were 82 patients with type 2 diabetes and 78 controls matched for age and sex. Restless legs syndrome was higher among patients with diabetes (31.7% vs. 10.3%%) with a significant statistical difference, P-<0.05. A direct positive relationship was found between restless legs syndrome and diabetic neuropathy (Wald=5.48, P-value=0.019, 95%CI 1.70-410.76), no relationship was found between RLS, diabetic retinopathy, glycated hemoglobin, sex, and neck circumference, P-values (0.757, 0.804, 0.317, and 0.361 respectively). Conclusion Restless legs syndrome was prevalent among patients with type 2 diabetes and was more common among patients with diabetic neuropathy, no relationship was found between restless legs syndrome, age, sex, neck circumference, HbA1 c , and retinopathy

Association between restless legs syndrome and peripheral neuropathy: A systematic review and meta‐analysis

“…The prevalence of RLS in DM2 patients found in studies with different designs ranges from 8.0% to 28.3% (mean 15.5%, 95% CI 14.3%–16.7% according to pooled data, Figure 3a) and, according to this meta‐analysis, has been found to be significantly higher than that found in controls [30,31,34,36,43] (Figure 3b). The frequency of RLS in patients with diabetic PN/PNP ranged from 10.6% to 40.3% [32–44] being 27.0% (95% CI 23.9%–30.2%) according to the pooled data (Figure 3c). Finally, the frequency of PN/PNP in patients with DM2 and RLS ranged from 14.6% to 92.6% (37.4% with 95% CI 33.2%–41.5% for pooled data) [31,32,34–36,38,39,41–44] (Figure 3d) and was significantly higher than that found in patients with DM2 who did not have RLS [31,32,34,36,38,39,42–44] (Figure 3e; funnel plot shown in Figure S12).…”

“…• None of the parameters studied showed a significant correlation with RLS severity. These results suggest that abnormal sensory perception in iRLS could be related to an alteration of central somatosensory processing instead of small fibre abnormalities [32,34,[42][43][44][45] the other four did not find significant differences [31,36,38,39] although the meta-analysis showed a significantly higher frequency of PN/ PNP in patients with RLS. The prevalence of RLS in patients with DM2 has been reported to be higher [34,36,43] or similar [30,31] compared with 'controls' suffering from other (inactive) endocrine diseases, but the results of the meta-analysis finally revealed an increased risk for RLS in patients diagnosed with DM2.…”

“…The frequency of RLS in patients with diabetic PN/PNP ranged from 10.6% to 40.3% [32–44] being 27.0% (95% CI 23.9%–30.2%) according to the pooled data (Figure 3c). Finally, the frequency of PN/PNP in patients with DM2 and RLS ranged from 14.6% to 92.6% (37.4% with 95% CI 33.2%–41.5% for pooled data) [31,32,34–36,38,39,41–44] (Figure 3d) and was significantly higher than that found in patients with DM2 who did not have RLS [31,32,34,36,38,39,42–44] (Figure 3e; funnel plot shown in Figure S12). After excluding those studies that did not use the 1995 [16] 2003 [17] or 2014 [18] IRLSSG diagnostic criteria for RLS, and/or did not confirm the presence of PN/PNP by neurophysiology [30,31,32,34,36,41–44], the prevalence of RLS in patients with diabetic PN/PNP was 15.2%–33.3% (mean 25.2%, 95% CI 21.1%–29.3%) (Figure 3f).…”

“…and type 2 (DM2) and/or with diabetic PN/PNP has been the subject of several studies, which are summarized in Table 3 [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. The prevalence of RLS in DM2 patients found in studies with different designs ranges from 8.0% to 28.3% (mean 15.5%, 95% CI 14.3%-16.7% according to pooled data, Figure 3a) and, according to this meta-analysis, has been found to be significantly higher than that found in controls [30,31,34,36,43] (Figure 3b). 3d) and was significantly higher than that found in patients with DM2 who did not have RLS [31,32,34,36,38,39,[42][43][44] (Figure 3e; funnel plot shown in Figure S12).…”

The Confusing Tale of Restless Leg Syndrome and Diabetic Neuropathy: A Case-control Study among Patients with Diabetes Mellitus in Tabuk City, Saudi Arabia

“…Restless Leg Syndrome (RLS) characterizes by a tendency to move the limbs with unpleasant sensations increasing at night and improved by rest. The diagnosis is usually clinical; the association of restless leg syndrome with diabetic neuropathy is controversial [8]. RLS as a common sleep disorder is treatable; however, it may mimic diabetic neuropathy leading to treatment delay [9].…”