Response: Association between Diabetic Polyneuropathy and Chronic Complications in Type 2 Diabetic Patients (Diabetes Metab J 2011;35:390-6)

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We appreciate the interest and comments on our study, “Association between diabetic polyneuropathy and cardiovascular complications in type 2 diabetic patients,” which was published in Diabetes & Metabolism Journal 2011;35:390-6. Diabetic polyneuropathy is one of the complications of chronic diabetes related to long-standing hyperglycemia and is a common cause of morbidity in diabetic patients. Diabetic polyneuropathy develops under the conditions of chronic hyperglycemia, associated with metabolic derangements and cardiovascular risk factors [1]. Recently, the close relationships between diabetic polyneuropathy and micro- or macroangiopathy have been reported [2-4]. Results from a populationbased study of type 2 diabetic patients in Sweden showed that peripheral sensory neuropathy, assessed by 10 g monofilament and vibration perception threshold was associated with retinopathy and overt nephropathy [2]. In the EURODIAB Prospective Complications Study, the risk factors for cardiovascular disease including hypertension, total cholesterol, smoking, and previous cardiovascular disease increased the incidence of abnormal vibration perception threshold in type 1 diabetes mellitus [5]. Several studies have reported associations between diabetic polyneuropathy and cardiovascular mortality [6-8]. In our study, we investigated the association between diabetic polyneuropathy assessed by electrophysiological testing and chronic complications in type 2 diabetic patients. In our study, the prevalence of diabetic retinopathy, nephropathy or autonomic neuropathy was higher in patients with diabetic polyneuropathy. Diabetic polyneuropathy was associated with a high prevalence of risk factors for macrovascular complications, such as poor metabolic control, dyslipidemia, and hypertension. In multivariate analysis, diabetic polyneuropathy was independently associated with cardiovascular disease (odds