COMPARATIVE EVALUATION OF COMPLICATIONS OF DIABETES MELLITUS - NEUROPATHY AND ANGIOPATHY.
Abstract
There is no consensus on what common symptoms of neuropathy and diabetic angiopathy in diabetes mellitus may cause their pathogenetic mechanisms. In exploring these questions, studies of nerve conduction and common and local clinical manifestations of diabetic angiopathy have been performed. Regardless of symptoms, 277 patients with type 2 diabetes mellitus (202 men, 75 women; mean age 64.1 years [51-79 years]; mean duration of diabetes mellitus 12.0 years [5-19 years]; HbA1C(glycolized hemoglobin) 8.9% [5.112.1]; half [n = 142] without drug treatment) were included in the review. Nerve conduction studies were performed for the following symptoms: mononeuropathy (unilateral, bilateral), multiple mononeuropathy, and polyneuropathy. Atherosclerosis tests were performed in 166 patients: cardiac ankle vascular index (CAVI) and carotid ultrasound. Neuropathy was observed in 89 patients (42 patients without neuropathy symptoms; control group). The more frequent symptoms were 1) multiple mononeuropathy (28%), 2) bilateral mononeuropathy (21%),3) polyneuropathy (18%) and, 3) unilateral mononeuropathy (13%). A combination of demyelination and axonal damage has been proven. Duration of diabetes mellitus was associated with bilateral mononeuropathy (11.5 years), multiple mononeuropathy (13.8 years) and polyneuropathy (16.4 years) compared to controls (8.6 years) (p<0.05). HbA1C was associated with polyneuropathy (p <0,05). Increased risk of atherosclerosis, was associated with bilateral mononeuropathy, multiple mononeuropathy and polyneuropathy (p <0.05). It was found that multiple mononeuropathy and angiopathy is the most common symptom in diabetes mellitus.
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