Endocrine Abstracts

Background: Diabetic neuropathy is the most prevalent chronic complications of diabetes. This heterogeneous group of conditions affects different parts of the nervous system and presents with diverse clinical manifestations. Diabetic peripheral neuropathy (DPN) is one of the common complication of type 2 diabetes and can lead to foot ulcer, gangrene or amputation. The risk of developing diabetic neuropathy increases with age, diabetes duration and poor control of blood glucose. About 60% to 70% of all people with diabetes will eventually develop DPN. Hypertiglyceridemia is a typical lipid disorder in patients with poorly controlled diabetes mellitus.

The Aim: Of this study was to assess the effect of hypertiglyceridemia on peripheral neuropathy in patient with type 2 diabetes(T2DM).

Methods: 62 T2DM patients with peripheral neuropathy were enrolled in this study; among them, 33 men and 29 women (Study Group/SG). Their mean age was 56±7 yrs and diabetes duration varied from 5 to10 yrs. In all SG patients hypertiglyceridemia was diagnosed. 50 patients with the same age, sex and diabetes duration, but without DPN and normal triglycerides (TG) were used as controls (CG). HbA1c in SG was 8,1±1,2% and in CG - 7,7±1,1%. According to current Guidelines, to assess DPN, following neuropathy tests were performed in all patients: 10-g monofilament test, tip-term/temperature test, vibration test with the 128-Hz tuning fork, pick tests and neurological examination with Sudoscan. Results of all neurological tests in SG patients (monofilament test, tip-term/temperature test, vibration test) were positive, Sudoscan examination revealed presence of small fiber neuropathy. In CG patients all tests, except Sudoscan, were negative, while Sudoscan revealed small fiber damage. Association between hypertiglyceridemia and DPN was assessed. Serum triglyceride levels in SG patients were elevated(mean TG level 299± 45mg/dl, while in CG patients - 100±20mg/dl).

Results: According to neurological examinations prevalence of DPN in SG patients comprised 64,5% (40 cases). TG concentration was significantly elevated in T2DM patients with DPN when compared to patients without DPN and normal TG levels(P=0,005). Elevated serum triglyceride levels were associated with DPN(P<0,044).

Discussion: This study shows that increased levels of serum triglycerides may play important clinical role in development of DPN in T2DM patients in Georgia. The problem needs further investigation with other important parameters.