The Prevalence and Characteristics of Diabetic Polyneuropathy in Japanese Type 2 Diabetic Patient

Abstract

This study aims to investigate the prevalence and characteristics of diabetic polyneuropathy (DPN) in type 2 diabetic patients registered in the Japan Diabetes Complication and its Prevention Prospective (JDCP) study. In the JDCP study, 6,338 diabetic patients who had been treated by diabetes specialists were registered in 2007-9. Of these, 5,451 patients with type 2 diabetes (61.4 years-old, duration of diabetes 10. 8 years, BMI 24.5 and HbA1c 7.42%) who could be evaluated for DPN were analyzed by using t-test, chi-square test and logistic regression analysis. The diagnosis of DPN was performed by using simple diagnostic criterion for diabetic polyneuropathy proposed by Diabetic Neuropathy Study Group in Japan. This criterion should meet two or more of the following three items: 1) sensory symptoms (SS) considered to be due to DPN, 2) bilaterally decreased or absent Achilles tendon reflex (ATR) and 3) decreased vibratory perception threshold (VPT) in bilateral medical malleoli. The prevalence of positive SS, bilaterally decreased/absent ATR and symmetric decrease in VPT were 25.8%, 40.9% and 48.1%, respectively. Based on simple diagnostic criterion, DPN was observed in 35.8% of the total. The decrease/absence of bilateral ATR showed high sensitivity (87.2%) and specificity (84.8%) in the diagnosis of DPN. In the group with DPN, we investigated the odds ratio (OR) of covariates for neuropathy and found that the age (OR 1.58, p<0.001), the duration of diabetes (OR 1.32, p<0.001), BMI (OR 1.20, p<0.001), T-cho (OR 0.98, p<0.05), insulin therapy (OR 1.62, p<0.001), systolic blood pressure (OR 1.06, p<0.01), HbA1c (OR 1.17, p<0.001), oral administration of biguanide (OR 1.19, p<0.01) and exercise therapy (OR 0.83, p<0.05) showed significant. Baseline survey of the JDCP study, the prevalence of DPN in type 2 diabetic patients was similar to that reported previously, suggesting the possibility that the evaluation of bilateral ATR is useful for the diagnosis of DPN. Disclosure H. Kamiya: Other Relationship; Self; MSD K.K., Ono Pharmaceutical Co., Ltd., Sanofi K.K., AstraZeneca, Astellas Pharma KK, Eli Lilly and Company, Novartis Pharma K.K., Dainippon Sumitomo Pharma Co., Ltd, Boehringer Ingelheim Pharmaceuticals, Inc., Takeda Pharmaceutical Co., Ltd, Ono Pharmaceutical Co., Ltd.. A. Watarai: None. M. Baba: None. R. Nishimura: Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Astellas Pharma US, Inc., Eli Lilly and Company, Abbott, Medtronic, MSD K.K., Novo Nordisk A/S, Sanofi, Takeda Development Center Asia, Pte. Ltd., Kissei Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd.. N. Tajima: None. J. Nakamura: Other Relationship; Self; Astellas Pharma US, Inc., AstraZeneca, Ono Pharmaceutical Co., Ltd., MSD K.K., Kyowa Hakko Kirin Co., Ltd., Kowa Pharmaceuticals America, Inc., Sanofi K.K., Taisho Pharmaceutical Co., Ltd., Takeda Development Center Asia, Pte. Ltd., Mitsubishi Tanabe Pharma Corporation, Eli Lilly and Company, Novartis Pharma K.K., Pfizer Inc..