Established diabetic neuropathy seems irreversible despite improvements in metabolic and vascular risk markers - A retrospective case-control study in a hospital patient cohort
Authors: Coppini, D.V., Spruce, M.C., Thomas, P. and Masding, M.G.
Journal: Diabetic Medicine
Volume: 23
Issue: 9
Pages: 1016-1020
eISSN: 1464-5491
ISSN: 0742-3071
DOI: 10.1111/j.1464-5491.2006.01934.x
Abstract:Aims: To gain insight into the natural history of diabetic peripheral neuropathy (DPN) and its risk factors by means of sequential quantitative testing in a hospital patient cohort. Methods: A retrospective case-control study involving 300 diabetic patients (100 subjects with neuropathy and 200 control subjects) attending Poole Hospital diabetes clinic between 1995 and 2002. All subjects had a detailed annual clinic assessment including vibration perception threshold (VPT) and physical and metabolic assessments and were categorized according to neuropathy status. Established neuropathy was defined as a VPT > 25 V. Cross-sectional data were analysed by means of a t-test and longitudinal data by means of anova. Results: VPTs increased over time in neuropathy patients, with no change in control patients (P < 0.001). Glycaemic control was better over that period in control patients but the rate of improvement in HbA1c over time was similar in both groups. Triglyceride and high-density lipoprotein cholesterol levels improved in both groups, with significantly greater change in the control group. Conclusions: Data on reversibility of neuropathy are scarce and our 8-year series shows a continual deterioration in VPT in patients with a threshold > 25 V despite modest improvements in glycaemic control and lipid parameters. This work also supports a vascular association with neuropathy and identifies neuropathic patients as a high-risk cardiovascular group in whom, despite little influence on neuropathy itself, the above metabolic factors should be actively addressed. © 2006 The Authors.
Source: Scopus
Established diabetic neuropathy seems irreversible despite improvements in metabolic and vascular risk markers--a retrospective case-control study in a hospital patient cohort.
Authors: Coppini, D.V., Spruce, M.C., Thomas, P. and Masding, M.G.
Journal: Diabet Med
Volume: 23
Issue: 9
Pages: 1016-1020
ISSN: 0742-3071
DOI: 10.1111/j.1464-5491.2006.01934.x
Abstract:AIMS: To gain insight into the natural history of diabetic peripheral neuropathy (DPN) and its risk factors by means of sequential quantitative testing in a hospital patient cohort. METHODS: A retrospective case-control study involving 300 diabetic patients (100 subjects with neuropathy and 200 control subjects) attending Poole Hospital diabetes clinic between 1995 and 2002. All subjects had a detailed annual clinic assessment including vibration perception threshold (VPT) and physical and metabolic assessments and were categorized according to neuropathy status. Established neuropathy was defined as a VPT > 25 V. Cross-sectional data were analysed by means of a t-test and longitudinal data by means of ANOVA. RESULTS: VPTs increased over time in neuropathy patients, with no change in control patients (P < 0.001). Glycaemic control was better over that period in control patients but the rate of improvement in HbA1c over time was similar in both groups. Triglyceride and high-density lipoprotein cholesterol levels improved in both groups, with significantly greater change in the control group. CONCLUSIONS: Data on reversibility of neuropathy are scarce and our 8-year series shows a continual deterioration in VPT in patients with a threshold > 25 V despite modest improvements in glycaemic control and lipid parameters. This work also supports a vascular association with neuropathy and identifies neuropathic patients as a high-risk cardiovascular group in whom, despite little influence on neuropathy itself, the above metabolic factors should be actively addressed.
Source: PubMed
Established diabetic neuropathy seems irreversible despite improvements in metabolic and vascular risk markers—a retrospective case–control study in a hospital patient cohort
Authors: Coppini, D.V., Spruce, M.C., Thomas, P. and Masding, M.G.
Journal: Diabetic Medicine
Volume: 23
Pages: 1016-1020
ISSN: 0742-3071
Abstract:Aims To gain insight into the natural history of diabetic peripheral neuropathy (DPN) and its risk factors by means of sequential quantitative testing in a hospital patient cohort.
Methods A retrospective case–control study involving 300 diabetic patients (100 subjects with neuropathy and 200 control subjects) attending Poole Hospital diabetes clinic between 1995 and 2002. All subjects had a detailed annual clinic assessment including vibration perception threshold (VPT) and physical and metabolic assessments and were categorized according to neuropathy status. Established neuropathy was defined as a VPT > 25 V. Cross-sectional data were analysed by means of a t -test and longitudinal data by means of ANOVA .
Results VPTs increased over time in neuropathy patients, with no change in control patients ( P < 0.001). Glycaemic control was better over that period in control patients but the rate of improvement in HbA 1c over time was similar in both groups. Triglyceride and high-density lipoprotein cholesterol levels improved in both groups, with significantly greater change in the control group.
Conclusions Data on reversibility of neuropathy are scarce and our 8-year series shows a continual deterioration in VPT in patients with a threshold > 25 V despite modest improvements in glycaemic control and lipid parameters.
This work also supports a vascular association with neuropathy and identifies neuropathic patients as a high-risk cardiovascular group in whom, despite little influence on neuropathy itself, the above metabolic factors should be actively addressed.
Source: Manual
Established diabetic neuropathy seems irreversible despite improvements in metabolic and vascular risk markers--a retrospective case-control study in a hospital patient cohort.
Authors: Coppini, D.V., Spruce, M.C., Thomas, P. and Masding, M.G.
Journal: Diabetic medicine : a journal of the British Diabetic Association
Volume: 23
Issue: 9
Pages: 1016-1020
eISSN: 1464-5491
ISSN: 0742-3071
DOI: 10.1111/j.1464-5491.2006.01934.x
Abstract:Aims
To gain insight into the natural history of diabetic peripheral neuropathy (DPN) and its risk factors by means of sequential quantitative testing in a hospital patient cohort.Methods
A retrospective case-control study involving 300 diabetic patients (100 subjects with neuropathy and 200 control subjects) attending Poole Hospital diabetes clinic between 1995 and 2002. All subjects had a detailed annual clinic assessment including vibration perception threshold (VPT) and physical and metabolic assessments and were categorized according to neuropathy status. Established neuropathy was defined as a VPT > 25 V. Cross-sectional data were analysed by means of a t-test and longitudinal data by means of ANOVA.Results
VPTs increased over time in neuropathy patients, with no change in control patients (P < 0.001). Glycaemic control was better over that period in control patients but the rate of improvement in HbA1c over time was similar in both groups. Triglyceride and high-density lipoprotein cholesterol levels improved in both groups, with significantly greater change in the control group.Conclusions
Data on reversibility of neuropathy are scarce and our 8-year series shows a continual deterioration in VPT in patients with a threshold > 25 V despite modest improvements in glycaemic control and lipid parameters. This work also supports a vascular association with neuropathy and identifies neuropathic patients as a high-risk cardiovascular group in whom, despite little influence on neuropathy itself, the above metabolic factors should be actively addressed.Source: Europe PubMed Central