Distal Symmetric and Cardiovascular Autonomic Neuropathies in Brazilian Individuals with Type 2 Diabetes Followed in a Primary Health Care Unit: A Cross-Sectional Study

Author(s)

de Matos, Mozania Reis ^{[1, 2]} ; Santos-Bezerra, Daniele Pereira ^[3] ; Dias Cavalcante, Cristiane das Gracas ^[2] ; de Carvalho, Jacira Xavier ^[2] ; Leite, Juliana ^[1] ; Januario Neves, Jose Antonio ^[1] ; Admoni, Sharon Nina ^[3] ; Passarelli, Marisa ^{[1, 4]} ; Parisi, Maria Candida ^[5] ; Correa-Giannella, Maria Lucia ^{[1, 3]}

Affiliation

^[1] Univ Nove Julho UNINOVE, Programa Posgrad Med, Rua Vergueiro 235, 2 Subsolo, BR-01504001 Sao Paulo - Brazil

^[2] Unidade Bas Saude Dra Ilza Weltman Hutzler, Rua Coronel Walfrido de Carvalho, BR-02472180 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Lab Carboidratos & Radioimunoensaio LIM 18, Fac Med, Hosp Clin HCFMUSP, Ave Dr Arnaldo 455, Sala 3321, BR-01246903 Sao Paulo - Brazil

^[4] Univ Sao Paulo, Hosp Clin HCFMUSP, Lab Lipides LIM 10, Fac Med, Ave Dr Arnaldo 455, Sala 3305, BR-01246903 Sao Paulo - Brazil

^[5] Univ Estadual Campinas, Fac Med, Dept Clin Med, Div Endocrinol, UNICAMP, Rua Tessalia Vieira Camargo, 126 Cidade Univ, BR-13083887 Campinas - Brazil

• Document type: Journal article
• Source: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH; v. 17, n. 9 MAY 2020.
• Web of Science Citations: 0

Abstract

The paucity of epidemiological data regarding diabetes complications in Brazil motivated us to evaluate the prevalence rates of distal symmetric polyneuropathy (DSP) and of cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes (T2D) followed in a primary care unit. A total of 551 individuals (59.3% women, 65 years old; diabetes duration of 10 years; HbA1c of 7.2%, medians) were included in this cross-sectional study. DSP was diagnosed by sum of the Neuropathy Symptoms Score (NSS) and Modified Neuropathy Disability Score (NDS) and by the Semmes-Weinstein monofilament. CAN was diagnosed by cardiovascular autonomic reflex tests combined with spectral analysis of heart rate variability. The prevalence rates of DSP were 6.3% and 14.3%, as evaluated by the sum of NSS and NDS and by the Semmes-Weinstein monofilament, respectively. Those with DSP diagnosed by monofilament presented longer diabetes duration, worse glycemic control and a higher stature. The prevalence rates of incipient and definitive CAN were 12.5% and 10%, respectively. Individuals with definitive CAN presented a higher frequency of hypercholesterolemia and of arterial hypertension. The higher prevalence rate of DSP with the use of the monofilament suggests that it may be a more appropriate tool to diagnose DSP in the primary care setting in Brazil. (AU)

• FAPESP's process: 18/12265-2 - Changes in the glucose transporters expression in central nervous system: correlation between Type 3 Diabetes mellitus and Alzheimer's Disease
• Grantee: Daniele Pereira dos Santos Bezerra
• Support Opportunities: Scholarships in Brazil - Post-Doctoral