Somatic neuropathy is an independent predictor of all‐ and diabetes‐related mortality in type 2 diabetic patients: a population‐based 5‐year follow‐up study (KCIS No. 29)

Abstract

Background and purpose: To investigate the relationships of diabetic neuropathy to all-cause and diabetes-related mortality in patients with type 2 diabetes after controlling for significant correlates. Methods: We examined 326 patients diagnosed as diabetic polyneuropathy by nerve conduction study in Keelung city, Taiwan, in 2002 and followed them up to ascertain the cause and date of death until the end of 2006. The cause and date of death were recorded for the deceased patients. Information on significant correlates in association with diabetic polyneuropathy and all-cause and diabetes-related mortality was also collected. Results: With median follow-up time of 62.28 months, 44 patients with type 2 diabetes died. The cause of death related to diabetes accounted for 59% (n = 26) of the deceased. Univariate analysis shows that the presence of diabetic neuropathy confers higher risk for all-cause mortality (hazard ratio [HR] = 4.88) and mortality from diabetes (HR = 6.58). The significant finding still persisted after adjustment for age, gender, blood pressure, smoking, history of cardiovascular/cerebrovascular disease, duration of diabetes, waist circumference, fasting plasma glucose, total cholesterol, hemoglobin, and creatinine (adjusted HR = 4.44 for all-cause death and adjusted HR = 11.82 for diabetes-related mortality, respectively). Conclusions: Diabetic polyneuropathy was an independent predictor for all-cause and diabetes-related mortality. The presence of neuropathy together with other significant prognostic factors is informative to predict all-cause death and death from diabetes-related disease for patients diagnosed as type 2 diabetes.

Painful Diabetic Neuropathy in Japanese Diabetic Patients Is Common but Underrecognized

“…In addition, diabetic peripheral neuropathy is associated not only with significant reduction in quality of life (QOL) but also with increased mortality [2]. The prevalence of diabetic peripheral neuropathy is 47% of all diabetic patients when nerve conduction testing is used for diagnosis [3].…”

Should diabetes still be considered a coronary artery disease equivalent?

“…The Early Treatment Diabetic Retinopathy Study also showed that retinopathy is associated with increased mortality. 30 This has been confirmed in the meta-analysis by Kramer et al 34 Increased mortality has also been reported with both somatic 30,35 and autonomic Diabetes as a coronary artery disease equivalent Magri and Fava 761 neuropathy. 36,37 Tightly controlled blood pressure improved outcome in diabetic patients in both the United Kingdom Prospective Diabetes Study 38 and in the Hypertension Optimal Treatment Trial.…”

Influence of Diabetes and Hemodialysis against Nerve Conduction Studies

“…The relationship between the presence of neuropathy were assessed by NCS and future mortality in diabetic patients [27,28]. Mortality were increased when a patient had neuropathic history and higher initial A1C, in which neuropathic history nearly doubled the mortality risk [hazard ratio of 1.95] whereas an A1C of >8.5% had 1.64 hazard ratio [27].…”

“…Adjusted for other common risk factors, the hazard from neuropathy for all-cause mortality was 4.44 and for diabetes-related mortality were 11.82. Consequently, neuropathy increased the risk of diabetes-related mortality more than 10-fold when corrected for other risk factors [28].…”