Prevalence and Risk Factors of Somatic and Autonomic Neuropathy in Prediabetic and Diabetic Patients

Abstract

Aims/Hypothesis: To investigate the prevalence and correlates of somatic and autonomic neuropathies concurrently in prediabetic and diabetic subjects in the general population. Subjects and Methods: Nerve conduction and heart rate variability studies were used for detecting both types of diabetic neuropathy. Of 1,576 inhabitants, 143 persons were identified as prediabetic or having diabetic mellitus. One hundred and thirty-three persons completed a nerve conduction test and 118 persons a valid heart rate variability test. Significant correlates responsible for diabetic neuropathies were also collected. Results: The prevalence rates of definite, probable and no somatic neuropathy were 9.0% (12/133), 20.3% (27/133) and 70.7% (94/133), respectively. The corresponding figures for autonomic neuropathy were 14.4% (17/118), 54.2% (64/118) and 31.4% (37/118). The prevalence rate for the presence of both neuropathies was 16.9%. In a univariate analysis, age, renal insufficiency, HbA1c and fasting glucose level were significantly associated with somatic neuropathy whereas only systolic blood pressure was statistically significantly associated with autonomic neuropathy. In a multivariate analysis, systolic blood pressure and fasting glucose level were positively associated with somatic neuropathy and systolic blood pressure remained statistically significant for autonomic neuropathy. Conclusions: The prevalence of autonomic neuropathy is twofold compared with somatic neuropathy. Concurrence of the two kinds of neuropathy was approximately half of sole somatic neuropathy and a quarter of sole autonomic neuropathy. Systolic blood pressure and fasting glucose level were related to somatic neuropathy whereas only systolic blood pressure was correlated with autonomic neuropathy.