Endocrine Abstracts

Introduction: Diabetic neuropathy is the most common cause of neuropathy worldwide and is known to affect approximately half of all diabetic patients. It significantly impairs the quality of life of patients.

Aim of the study: To establish the predictive factors of distal symmetric polyneuropathy (DSPN) in diabetic patients.

Methods: This is a descriptive cross-sectional study including 116 patients. The diagnosis of PNDS was established according to the MNSI (Michigan Neuropathy Screening Instrument) and DN4 (Neuropathic Pain Diagnostic Questionnaire) scores. We divided the patients into two groups: group one (G1) patients with DSPN (N=67) and group two (G2) without DSPN (N=49). Then, using SPSS software, we were able to perform a multivariate study on independent predictive factors of DSPN as well as a univariate study of factors associated with this complication.

Results: Among the sociodemographic factors, only age was predictive of DPN with P = 0.005 (mean age: G1=64.85 +/- 12.56 years versus 58.27 +/- 11.88 years for G2). The analysis of the history showed that: nephropathy (P = 0.002), retinopathy (P < 0.001), myocardial infarction (P = 0.037), stroke (P = 0.020), hypertension (P < 0.001) and dyslipidemia (P = 0.006) were associated with DSPN. Symmetrical and peripheral polyneuropathy was found in 64 subjects with a diabetes duration of more than 5 years (P = 0.015), in 57 with unbalanced diabetes (P = 0.024) and in 34 with a history of hospitalization (P < 0.001). Regarding treatments, biguanides (P = 0.001), sulfonamides (P = 0.01) and insulin (P < 0.001) were associated with symmetric and peripheral polyneuropathy. Comparison between the two groups according to biological data showed a significant difference in creatinemia (P = 0.011), blood glucose (P = 0.030) and a significant increase in HbA1c in the neuropathy group with P = 0.001. On multivariate analysis, the independent predictors of DSPN were retinopathy and hypertension.

Conclusion: Age, nephropathy, retinopathy, history of myocardial infarction and stroke, and the presence of other cardiovascular risk factors such as dyslipidemia and hypertension, as well as the length of time the patient has had diabetes, are the main predictive factors for distal and symmetrical polyneuropathy in patients living with diabetes.