Comparison of Diabetic Polyneuropathy and Cardiac Autonomic Neuropathy in Type 1 and Type 2 Diabetes Mellitus
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients and Study Design
2.2. Physical Examination and Laboratory Assessment
2.3. Diabetic Polyneuropathy Assessment
2.3.1. Clinical Neurological Examination
2.3.2. Current Perception Threshold Measurement
2.3.3. Nerve Conduction Studies
2.4. Cardiac Autonomic Neuropathy Assessment
2.5. Statistical Analyses
3. Results
4. Discussion
4.1. Diagnostic Method Comparison
4.2. Risk Factors and Comorbidities Associations
4.3. Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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T1DM (n-66) | T2DM (n-79) | p Value | |
---|---|---|---|
Demographic and Disease Characteristics | |||
Male/female, n (%) | 34/32 (51.5/48.5) | 32/47 (40.5/59.5) | 0.241 ⁂ |
Age (years) | 40.8 ± 15.2 | 59.8 ± 11.6 | <0.001 ⁑ |
Diabetes duration (years) | 14.1 ± 13.4 | 11.9 ± 8.1 | 0.927 ⁑ |
BMI (kg/m2) | 23.7 ± 3.5 | 35.1 ± 6.2 | <0.001 ⁑ |
HbA1c (%) | 9.4 | 10.3 | 0.091 ⁑ |
eGFR, (mL/min/1.73 m2) | 90.6 ± 24.8 | 86.9 ± 17.1 | 0.131 ⁑ |
DM Complications and Concomitant Diseases | |||
Dyslipidemia, n (%) | 27 (40.9) | 63 (79.7) | <0.001 ⁂ |
Obesity, n (%) | 3 (4.5) | 60 (75.9) | <0.001 ⁂ |
Hypertension, n (%) | 23 (34.8) | 69 (87.3) | <0.001 ⁂ |
Retinopathy, n (%) | 25 (37.9) | 27 (34.2) | 0.729 ⁂ |
Nephropathy, n (%) | 15 (22.7) | 10 (12.7) | 0.126 ⁂ |
Abnormal Test | T1DM, n (%) | T2DM, n (%) | p Value |
---|---|---|---|
NDS, n = 145 * | 66 (100) | 79 (100) | |
Vibration perception | 32 (48.5) | 57 (72.2) | 0.006 |
Temperature perception | 17 (25.8) | 25 (31.6) | 0.589 |
Pin-prick perception | 12 (18.2) | 13 (16.5) | 0.828 |
Ankle reflexes | 11 (16.7) | 13 (16.5) | 0.549 |
CPT, n = 145 * | 66 (100) | 79 (100) | |
Lesion of large myelinated fibers | 23 (34.8) | 21 (26.6) | 0.365 |
Lesion of small myelinated fibers | 29 (43.9) | 28 (35.4) | 0.311 |
Lesion of small unmyelinated fibers, n (%) | 24 (36.4) | 20 (25.3) | 0.202 |
NCS, n = 85 * | 34 (51.5) | 51 (64.6) | |
Reduced peroneal motor amplitude | 14 (41.2) | 10 (19.6) | 0.048 |
Prolonged peroneal motor distal latency | 8 (23.5) | 3 (5.9) | 0.023 |
Reduced peroneal motor conduction velocity | 11 (32.4) | 6 (11.8) | 0.027 |
Reduced tibial motor amplitude | 5 (14.7) | 9 (17.6) | 0.775 |
Prolonged tibial motor distal latency | 3 (8.8) | 4 (7.8) | 1.000 |
Reduced tibial motor conduction velocity | 6 (17.6) | 7 (13.7) | 0.761 |
Reduced sural sensory amplitude | 15 (44.1) | 19 (37.3) | 0.647 |
Reduced sural sensory conduction velocity | 13 (38.2) | 17 (33.3) | 0.813 |
CARTs, n = 136 * | 62 (93.9) | 74 (93.7) | |
HR response to the deep breathing test | 12 (19.4) | 34 (45.9) | 0.001 |
HR response to Valsalva maneuver | 5 (8.1) | 10 (13.5) | 0.413 |
HR response to standing | 20 (32.3) | 31 (41.9) | 0.288 |
BP’s response to standing | 13 (21.0) | 14 (18.9) | 0.831 |
T1DM (n = 66) | T2DM (n = 79) | |||||
---|---|---|---|---|---|---|
DPN (−) | DPN (+) | p Value | DPN (−) | DPN (+) | p Value | |
N, (%) | 49 (74.2) | 17 (25.8) | 54 (68.4) | 25 (31.6) | ||
Age (years) | 36.2 ± 12.9 | 53.9 ± 14.0 | <0.001 ⁑ | 58.1 ± 11.9 | 63.4 ± 10.1 | 0.059 ⁑ |
Diabetes duration (years) | 9.7 ± 11.1 | 25.4 ± 12.9 | <0.001 ⁑ | 10.7 ± 8.6 | 14.8 ± 5.7 | 0.008 ⁑ |
eGFR, (mL/min/1.73 m2) | 93.9 ± 25.8 | 80.9 ± 18.8 | 0.002 ⁑ | 89.3 ± 15.2 | 82.0 ± 19.6 | 0.079 ⁑ |
Dyslipidemia, n (%) | 13 (26.5) | 14 (82.4) | <0.001 ⁂ | 42 (77.8) | 21 (84.0) | 0.764 ⁂ |
Hypertension, n (%) | 9 (18.4) | 14 (82.4) | <0.001 ⁂ | 45 (83.3) | 24 (96.0) | 0.157 ⁂ |
Retinopathy, n (%) | 11 (22.4) | 14 (82.4) | <0.001 ⁂ | 16 (29.6) | 11 (44.0) | 0.308 ⁂ |
Nephropathy, n (%) | 6 (12.2) | 9 (52.9) | 0.001 ⁂ | 6 (11.1) | 4 (16.0) | 0.717 ⁂ |
CAN | 11 (22.9) | 9 (64.3) | 0.008 ⁂ | 27 (54.0) | 17 (70.8) | 0.210 ⁂ |
T1DM (n = 62) | T2DM (n = 74) | |||||
---|---|---|---|---|---|---|
CAN (−) | CAN (+) | p Value | CAN (−) | CAN (+) | p Value | |
N, (%) | 42 (67.7) | 20 (32.3) | 30 (40.5) | 44 (59.5) | ||
Age (years) | 37.7 ± 13.3 | 43.8 ± 15.4 | 0.104 ⁑ | 56.1 ± 12.9 | 62.0 ± 10.2 | 0.04 ⁑ |
Diabetes duration (years) | 9.0 ± 10.6 | 22.0 ± 14.5 | 0.001 ⁑ | 10.3 ± 9.4 | 12.8 ± 6.7 | 0.091 ⁑ |
eGFR (mL/min/1.73 m2) | 98.1 ± 22.4 | 76.2 ± 25.9 | <0.001 ⁑ | 85.6 ± 19.2 | 87.8 ± 16.5 | 0.582 ⁑ |
Hypertension, n (%) | 7 (16.7) | 12 (60) | 0.001 ⁂ | 25 (83.3) | 39 (88.6) | 0.514 ⁂ |
Retinopathy, n (%) | 9 (21.4) | 13 (65.0) | 0.001 ⁂ | 4 (13.3) | 20 (45.5) | 0.005 ⁂ |
Nephropathy, n (%) | 4 (9.5) | 11 (55.0) | <0.001 ⁂ | 3 (10) | 6 (13.6) | 0.731 ⁂ |
Variables | β Coefficient | Standard Error | p Value | Odds Ratio | 95% Confidence Interval | |
---|---|---|---|---|---|---|
Polyneuro- pathy | Constant | –20.274 | 8.113 | 0.012 | ||
Age | 0.181 | 0.075 | 0.016 | 1.198 | (1.034, 1.389) | |
Diabetes duration | −0.018 | 0.050 | 0.720 | 0.982 | (0.891, 1.083) | |
eGFR | 0.073 | 0.040 | 0.063 | 1.076 | (0.996, 1.163) | |
Dyslipidemia | −0.508 | 1.526 | 0.739 | 0.602 | (0.030, 11.980) | |
Hypertension | 5.225 | 2.856 | 0.067 | 185.947 | (0.690, 50,122, 761) | |
Retinopathy | 0.864 | 1.614 | 0.592 | 2.374 | (0.100, 56.145) | |
Nephropathy | 4.836 | 2.567 | 0.060 | 125.952 | (0.822, 19,303.899) | |
Cardiac autonomic neuropathy | −0.323 | 1.380 | 0.815 | 0.724 | (0.048, 10.829) | |
Chi-square | 43.625, df–8, p < 0.001 | |||||
Cardiac autonomic neuropathy | Constant | 0.578 | 1547 | 0.708 | ||
Diabetes duration | 0.046 | 0.034 | 0.174 | 1.047 | (0.980, 1.118) | |
eGFR | −0.029 | 0.016 | 0.066 | 0.971 | (0.941, 1.002) | |
Hypertension | 0.479 | 0.856 | 0.576 | 1.614 | (0.301, 8.641) | |
Retinopathy | −0.276 | 0.928 | 0.766 | 0.759 | (0.123, 4.678) | |
Nephropathy | 1.831 | 0.851 | 0.031 | 6.241 | (1.178, 33.065) | |
Chi-square | 22.572, df–5, p < 0.001 |
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Šiaulienė, L.; Sereikė, I.; Lazutka, J.R.; Semigrejeviene, J.; Visockienė, Ž. Comparison of Diabetic Polyneuropathy and Cardiac Autonomic Neuropathy in Type 1 and Type 2 Diabetes Mellitus. Diabetology 2025, 6, 74. https://doi.org/10.3390/diabetology6080074
Šiaulienė L, Sereikė I, Lazutka JR, Semigrejeviene J, Visockienė Ž. Comparison of Diabetic Polyneuropathy and Cardiac Autonomic Neuropathy in Type 1 and Type 2 Diabetes Mellitus. Diabetology. 2025; 6(8):74. https://doi.org/10.3390/diabetology6080074
Chicago/Turabian StyleŠiaulienė, Laura, Ieva Sereikė, Juozas Rimantas Lazutka, Joana Semigrejeviene, and Žydrūnė Visockienė. 2025. "Comparison of Diabetic Polyneuropathy and Cardiac Autonomic Neuropathy in Type 1 and Type 2 Diabetes Mellitus" Diabetology 6, no. 8: 74. https://doi.org/10.3390/diabetology6080074
APA StyleŠiaulienė, L., Sereikė, I., Lazutka, J. R., Semigrejeviene, J., & Visockienė, Ž. (2025). Comparison of Diabetic Polyneuropathy and Cardiac Autonomic Neuropathy in Type 1 and Type 2 Diabetes Mellitus. Diabetology, 6(8), 74. https://doi.org/10.3390/diabetology6080074