Prevalence and spectrum of diabetic peripheral neuropathy and its correlation with insulin resistance - an experience from eastern India

Abstract

Aims: Diabetes mellitus is a public health problem worldwide, with diabetic neuropathy (DN) being a common complication. Studies indicate that, neurons can develop insulin resistance (IR) and thus may notrespond to the neurotrophic properties of insulin. Although studies existon the relation between DN and glycemic exposure index (GEi), work on correlation of DN with IR is rare. This study focused on the prevalence of neuropathies in DM patients and usefulness of IR as a marker of DN.

Methods: A cross sectional observational study was done. All patients satisfying American Diabetes Associationcriteria and none of the exclusion criteria were included.Totalsample size was 142. Main parameters studied were glycemic status, neurological signs, and nerve conduction study findings. Dyck grading was used for severity ofdistal symmetric polyneuropathy (DSPN). For statistical analysis, logistic and ordinal logistic regressions were used as appropriate.

Results: 34.5% of the sample had DN, the commonest type being DSPN (72.9%). The study population was equally divided in terms of gender and 88.7% were type 2 diabetic. About 62.5% neuropathic cases were asymptomatic. Occurrence of DN correlated significantly with duration of diabetes, FBSand IR. Age, when adjusted for other risk factors was not significantly correlated to neuropathy. The severity of DSPN correlated significantly with GEi but not with IR.

Conclusions: The prevalence of neuropathy was found to be similar to earlier western studies. This paper further establishes IR as a significant predictor for existence of DN, but it may not affect the progress of the neuropathy.