| Popis: |
AIMS Diabetes mellitus is a public health problem worldwide, with diabetic neuropathy (DN) being a common complication. Studies indicate that, neurons can also develop insulin resistance (IR) and thus cannot respond to the neurotrophic properties of insulin, leading to neuronal injury. Although some research works exist on the relation between DN and glycemic exposure index, the literature pertaining to correlation of the same with IR is unavailable in India. This study focused on the prevalence of neuropathies in DM patients & usefulness of IR as a marker of DN. METHODS A cross sectional observational study was done. All patients satisfying ADA (American Diabetes Association) criteria and none of the exclusion criteria were included. Total sample size was 142, selected by simple random sampling. Main parameters studied were glycemic status, neurological examination and nerve conduction study findings. GEi was calculated from HbA1c and duration of diabetes. IR was calculated using HOMA2 (Homeostatic model assessment) calculator from fasting blood sugar (FBS) and fasting c-peptide levels. Dyck grading was used for severity of DSPN (distal symmetric polyneuropathy). For statistical analysis, logistic and ordinal logistic regressions were used as appropriate. RESULTS 34.5% of 142 patients in the sample had DN, the commonest type being distal symmetrical polyneuropathy (DSPN) (72.9%). The study population was equally divided in terms of gender and 88.7% were type 2 diabetic. About 62.5% neuropathic cases were asymptomatic. Occurrence of DN was found to correlate significantly with duration of diabetes, FBS and IR. Age, when adjusted for other risk factors was not significantly correlated to neuropathy. There was no gender predilection too for the same. The severity of DSPN correlated significantly with GEi but not with IR. CONCLUSIONS The prevalence of neuropathy was found to be similar to earlier western studies. This paper further establishes IR as a significant predictor for existence of DN, but it may not affect the progress of the neuropathy. |
