title: Cardiovascular disease predicts diabetic peripheral polyneuropathy in subjects with type 2 diabetes: A 10-year prospective study.
abstract: The relationship between cardiovascular disease and diabetic peripheral neuropathy is mainly sustained by data retrieved from cross-sectional studies focused on cardiovascular risk factors. We aimed to assess the presence of cardiovascular disease as a risk factor for developing diabetic peripheral neuropathy in a type 2 diabetes mellitus population.
  
  
  
  A 10-year prospective, primary care, multicentre study in a randomly selected cohort. Cardiovascular disease presence included stroke, coronary artery disease and/or peripheral ischaemia. Diabetic peripheral neuropathy diagnosis was based on clinical neurological examination as well as the neuropathy symptoms score and nerve conduction studies.
  
  
  
  Three hundred and ten (N=310) patients were initially recruited. Two-hundred and sixty seven (N=267) patients were included in the study. Diabetic peripheral neuropathy cumulative incidence was 18.3% (95% confidence intervals 14.1-23.4; N=49). Diabetic peripheral neuropathy development was significantly more frequent in participants presenting with cardiovascular disease at baseline (P=0.01). In the final logistic regression analysis, the presence of cardiovascular disease remained associated with an increased risk for diabetic peripheral neuropathy (odds ratio 2.32, 95% confidence intervals 1.03-5.22) in addition to diabetes duration and low density lipoprotein-cholesterol levels.
  
  
  
  In our series, type 2 diabetes mellitus patients with cardiovascular disease at baseline present with an increased risk of developing diabetic peripheral neuropathy at 10 years of follow-up. Our results suggest that measures aimed at the prevention, control and treatment of cardiovascular disease can also help prevent diabetic peripheral neuropathy development.
authors.affiliation: Hospital Quirón-Teknon, Spain romeoj@ccf.org.
authors.forename: Juan
authors.initials: J
authors.lastname: Ybarra-Muñoz
authors.affiliation: Institut Universitari d'Investigació en Atenció Primaria (IDIAP) Jordi Gol, Spain Institut Catala de la Salut, Girona, Spain.
authors.forename: Jeronimo
authors.initials: J
authors.lastname: Jurado-Campos
authors.affiliation: Institut Universitari d'Investigació en Atenció Primaria (IDIAP) Jordi Gol, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Garcia-Gil
authors.affiliation: Institut Universitari d'Investigació en Atenció Primaria (IDIAP) Jordi Gol, Spain Universitat Autònoma de Barcelona, Spain.
authors.forename: Edurne
authors.initials: E
authors.lastname: Zabaleta-Del-Olmo
authors.affiliation: Institut Catala de la Salut, Girona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Mir-Coll
authors.affiliation: CEO Nursing, Hospital Clinic of Barcelona, Spain.
authors.forename: Adelaida
authors.initials: A
authors.lastname: Zabalegui
authors.affiliation: Endocrinology Department, Hospital Clinic of Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Vidal
authors.affiliation: Cleveland Clinic/Medina Hospital, Heart Failure Clinic, USA romeoj@ccf.org.
authors.forename: June H
authors.initials: JH
authors.lastname: Romeo
mesh_terms: D002318:Cardiovascular Diseases; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2; D006801:Humans; D011115:Polyneuropathies; D011446:Prospective Studies; D012307:Risk Factors
keywords: Cardiac autonomic neuropathy; cardiovascular disease; diabetic peripheral neuropathy; low density lipoprotein-cholesterol; prospective studies; type 2 diabetes mellitus