Prevalence of neuropathy in IDDM patients in Piemonte, Italy

• Published in: Diabetes care Vol. 16; no. 2; pp. 456 - 461
• Main Authors: VEGLIO, M, SIVIERI, R
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-02-1993
• Subjects: Associated diseases and complications; Biological and medical sciences; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Medical sciences; Italy; Europe; Endocrinopathy; Human; Nervous system diseases; Prevalence; Insulin dependent diabetes; Autoimmune disease; Complication; Duration; Peripheral nerve disease; Polyneuropathy; Age
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.16.2.456

OBJECTIVE
In view of the scarce data available in Italy, to assess the prevalence of neuropathy in various subgroups of IDDM patients living in the Piemonte region of Italy and to develop, based on existing guidelines, and test the practicality of a standardized assessment of diabetic neuropathy.
RESEARCH DESIGN AND METHODS
All IDDM patients (766) attending 23 outpatient clinics, evenly distributed in the region, were stratified into 3 age-groups (15–29, 30–44, and 45–59 yr) and into 3 groups of diabetes duration (1–7, 8–14, and ≥ 15 yr). A random sample of 467 patients was selected; 81% of whom participated in the studies (196 men and 183 women). The following data were collected: personal and clinical data, structured questionnaire (SQ), neurological examination (NE), vibration sensation (tuning fork) (VS), and two cardiovascular tests (CTs). Patients were classified as follows: stage 0, (no neuropathy) <2 abnormalities among SQ, NE, VS, and CT; stage 1, (asymptomatic neuropathy) > 1 abnormality among NE, VS, and CT; stage 2, (symptomatic neuropathy) abnormalities in SQ and in NE, and/or VS, and/or CT.
RESULTS
The prevalence rates were as follows: stage 0 = 71.5%, stage 1 = 7.2%, and stage 2 = 21.3% and all had a 95% CI. No difference was found between men and women. The prevalence of neuropathy (stages 1 and 2) was higher (P < 0.01) in groups of longer diabetes duration or older age.
CONCLUSIONS
Polyneuropathy is a frequent complication in a north Italian IDDM population. Our results suggest that IDDM patients > 30 yr of age, with diabetes of > 15 yr duration, and who complain of symptoms suggestive of neuropathy, should be promptly assessed for the presence of diabetic polyneuropathy.