What question did this study set out to answer?

This research assesses the connection between diabetic peripheral neuropathy, vitamin B12 levels, and autonomic neuropathy in diabetes patients at high cardiovascular risk.

January 10, 2026Biomedicines0 citationsOpen Access

The Assessment of the Autonomic Polyneuropathy Through Sudoscan and Vitamin B12 in Patients with Type 2 Diabetes Mellitus and High Cardiovascular Risk or Established Cardiovascular Disease

Q: What does this research mean for the field?

Vitamin B12 is associated with cardiovascular risk in patients with type 2 diabetes, but not with the severity of diabetic peripheral neuropathy. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

CMCristina Alina MocanuŞtefan cel Mare University of Suceava TSTeodor SalmenCarol Davila University of Medicine and Pharmacy ASAnca Pantea Stoian

Key Result

Vitamin B12 was associated with cardiovascular risk in patients with type 2 diabetes, but not with the severity of diabetic peripheral neuropathy (p = 0.6).

Key Points

This research assesses the connection between diabetic peripheral neuropathy, vitamin B12 levels, and autonomic neuropathy in diabetes patients at high cardiovascular risk.
Conducted a cross-sectional analysis of 164 patients with type 2 diabetes.
Measured clinical and demographic data, including Toronto Clinical Neuropathy Score and vitamin B12 levels.
Utilized Sudoscan and assessed orthostatic hypotension.
65.9% of patients exhibited diabetic peripheral neuropathy.
No significant correlation found between Sudoscan results and DPN severity.
Vitamin B12 levels were related to cardiovascular risk, with a p-value of 0.04.
Orthostatic hypotension had limited diagnostic value for autonomic dysfunction.

Structured PICO

Is there a relationship between diabetic peripheral neuropathy symptoms, vitamin B12 levels, and autonomic neuropathy in patients with Type 2 Diabetes Mellitus and high cardiovascular risk?

Population

164 patients with Type 2 Diabetes Mellitus and high or very high cardiovascular risk or established cardiovascular disease from the Outpatient DM Department of Suceava County Hospital.

Outcome

Relationship between diabetic peripheral neuropathy (DPN) symptoms, vitamin B12 level, and autonomic neuropathysurrogate

Vitamin B12 levels do not correlate with diabetic peripheral neuropathy severity, but Sudoscan combined with clinical scores may aid in autonomic neuropathy screening and risk stratification in diabetic patients with high cardiovascular risk.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: Diabetes Mellitus (DM) is frequently associated with diabetic peripheral neuropathy (DPN) and cardiovascular diseases (CVD). The aim of this study is to assess the relationship between DPN symptoms, vitamin B12 level, and autonomic neuropathy in DM patients with high and very high CV risk or established CVD. Material and Methods: A cross-sectional analysis of 164 patients from the Outpatient DM Department of Suceava County Hospital from September 2025 was performed. The clinical, paraclinical, and demographic data were collected, including Toronto Clinical Neuropathy Score (TCNS), Sudoscan, Orthostatic Hypotension (OH), and B12 level. Results: In total, 65.9% of patients had DPN; the mean HbA1c was 8.22% ± 1.74. No significant correlation was obtained between autonomic neuropathy (Sudoscan) and DPN severity (p = 0.163) or between vitamin B12 and DPN (p = 0.6). Vitamin B12 was associated with CV risk assessed with Sudosan (p = 0.04). OH had limited diagnostic significance for autonomic dysfunction. Conclusions: No strong link was detected between B12 levels and DPN; thus, it cannot be considered a predictive marker. Objective DPN screening remains essential. Sudoscan is practical and non-invasive in assessing autonomic neuropathy, but only when combined with TCNS may it increase the DPN screening and risk stratification in high-CV-risk populations with DM.

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