Diabetic Neuropathy Prevalence and Its Associated Risk Factors in Two Representative Groups of Type 1 and Type 2 Diabetes Mellitus Patients from Bihor County.

BACKGROUND: Diabetic neuropathy has an important impact on the quality of life of affected individuals due to the presence of chronic symptoms like distal neuropathic pain, but it also influences the survival of diabetic patients, given that the clinical forms of diabetic neuropathy produce complications such as diabetic foot syndrome in distal peripheral neuropathy or life threatening arrhythmias in autonomic cardiac neuropathy. The prevalence of diabetic neuropathy in representative cohorts is very discordant in numerous studies, and our purpose was to evaluate the frequency of this microvascular complication in Bihor County and to determine some risk factors for its development in order to perform a more rigorous screening in certain risk groups. MATERIAL AND METHODS: We formed two representative cohorts for type 1 and type 2 diabetes mellitus population in our county and applied a questionnaire with three subsets of questions for sensitive, motor and autonomic symptoms. Every patient was evaluated by using semi quantitative tests for distal neuropathy and two tests for determination of cardiac autonomic neuropathy. RESULTS: The prevalence of diabetic neuropathy was 28.70% in patients with type 1 diabetes mellitus and 50.70% in those with type 2 diabetes mellitus. Distal neuropathy was the most frequent clinical form, autonomic neuropathy having a low prevalence. The same risk factors were associated (p<0.01) with an increased risk of diabetic neuropathy in both type 1 and type 2 diabetes mellitus: age, diabetes duration, HbA1 c, hypertension, dyslipidaemia, and other microvascular complications. CONCLUSION: Screening for distal symmetric polyneuropathy can be easily done by using a symptom questionnaire and semi quantitative tests, and it is important to consider the fact that over 50% of type 2 diabetes patients in the representative cohort were affected by the complication. Control of modifiable risk factors can reduce the risk of neuropathy development considering the lower frequency of neuropathy in the groups with good glycaemic control, normal blood pressure and absence of dyslipidaemia.