Diabetic neuropathy. Correlation with other diabetic microvascular complications

OBJECTIVE: We studied the frequency of neuropathy in Saudi patients with definite diabetic microvascular complications and compared it to patients without complications. A high frequency of neuropathy in patients with definite microvascular complications would suggest a vascular etiology.

METHODS: The study group consisted of 201 type-2 diabetic patients followed in the diabetic clinic of King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia. These patients were screened for microvascular disease. Only symmetrical distal sensory and motor neuropathy cases were included in the study. Screening for retinopathy was carried out according to Klien’s criteria and nephropathy was diagnosed if albuminuria, microalbuminuria, abnormal blood urea nitrogen or creatinine was present.

RESULTS: There was a strong correlation between the prevalence of diabetic peripheral neuropathy, retinopathy (P<0.001) and nephropathy (P<0.01), in patients with type 2 diabetes mellitus. This strong correlation suggests a common underlying pathogenesis.

CONCLUSION: We conclude that microangiopathy may be a major factor in the pathogenesis of diabetic neuropathy. Major risk factors for microangiopathy are the degree of glycemic control and duration of diabetes.