Potential risk factors for diabetic neuropathy: a case control study.
BACKGROUND
Diabetes mellitus type II afflicts at least 2 million people in Iran. Neuropathy is one of the most common complications of diabetes and lowers the patient's quality of life. Since neuropathy often leads to ulceration and amputation, we have tried to elucidate the factors that can affect its progression.


METHODS
In this case-control study, 110 diabetic patients were selected from the Shariati Hospital diabetes clinic. Michigan Neuropathic Diabetic Scoring (MNDS) was used to differentiate cases from controls. The diagnosis of neuropathy was confirmed by nerve conduction studies (nerve conduction velocity and electromyography). The multiple factors compared between the two groups included consumption of angiotensin converting enzyme inhibitors (ACEI), blood pressure, serum lipid level, sex, smoking, method of diabetes control and its quality.


RESULTS
Statistically significant relationships were found between neuropathy and age, gender, quality of diabetes control and duration of disease (P values in the order: 0.04, 0.04, < 0.001 and 0.005). No correlation was found with any atherosclerosis risk factor (high BP, hyperlipidemia, cigarette smoking).


CONCLUSIONS
In this study, hyperglycemia was the only modifiable risk factor for diabetic neuropathy. Glycemic control reduces the incidence of neuropathy, slows its progression and improves the diabetic patient's quality of life. More attention must be paid to elderly male diabetic patients with poor diabetes control with regard to regular foot examinations and more practical education.
Booya
Fargol
F
Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. fargolbooya@yahoo.com
Bandarian
Fatemeh
F
Larijani
Bagher
B
Pajouhi
Mohammad
M
Nooraei
Mahdi
M
Lotfi
Jamshid
J
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003929:Diabetic Neuropathies / Q000453:epidemiology* / Q000517:prevention & control; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors
D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin