Age as an independent factor for the development of neuropathy in diabetic patients

Abstract

Simona Popescu,1,2 Bogdan Timar,2,3 Flavia Baderca,4,5 Mihaela Simu,6,7 Laura Diaconu,1,2 Iulian Velea,8,9 Romulus Timar1,2 12nd Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 2Clinic of Diabetes, Nutrition and Metabolic Diseases, Emergency Clinical County Hospital, 3Department of Functional Sciences, 4Department of Microscopic Morphology, “Victor Babes” University of Medicine and Pharmacy, 5Service of Pathology, Emergency City Hospital, 6Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 7Clinic of Neurology, Emergency Clinical County Hospital, 8Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, 9Clinic of Pediatrics, Emergency Clinical County Hospital, Timisoara, Romania Abstract: Population aging is unprecedented, without parallel in the history of humanity. As type 2 diabetes mellitus is predominantly more prevalent in aging populations, this creates a major public health burden. Older adults with diabetes have the highest rates of major lower-extremity amputation, myocardial infarction, visual impairment, and end-stage renal disease of any age group. The aims of our study were to assess whether age is an independent factor for the occurrence of diabetic neuropathy (DN), and to evaluate the relationship between the presence and the severity of DN and the diabetes duration and blood glucose level. In this study, we enrolled 198 patients, previously diagnosed with type 2 diabetes mellitus. For all patients, we measured hemoglobin A1c (HbA1c), lipid profile, and body mass index and we assessed the presence and severity of DN using the evaluation of clinical signs and symptoms. Patients had a median age of 62 years, with a median of diabetes duration of 7 years; 55.1% of the patients were men and the average HbA1c in the cohort was 8.2%. The prevalence of DN according to Michigan Neuropathy Screening Instrument was 28.8%, being significantly and positively correlated with higher age (65 vs 59 years; P=0.001) and HbA1c (8.6% vs 8.0%; P=0.027). No significant correlations were observed between the severity of DN and diabetes duration, body mass index (31.9 vs 29.9 kg/m2), or the number of centimeters exceeding the normal waist circumference (25.2 vs 17.3 cm; P=0.003). In conclusion, age influences the presence of DN, independent on other risk factors. This influence persists even after adjusting for other, very important risk factors, like blood glucose level or diabetes duration. Keywords: peripheral neuropathy, elderly patients, type 2 diabetes mellitus, body mass index, hemoglobin A1c, diabetic neuropathy

Keywords

• peripheral neuropathy
• elderly patients
• type 2 diabetes mellitus