Prevalência e fatores relacionados ao comprometimento dos nervos periféricos em diabéticos tipo II assintomáticos

Abstract

Diabetes mellitus is of great importance because of the high prevalence in the world population and diabetic neuropathy is a complication of high morbidity and corresponds to seventy percent of non-traumatic amputations, so early diagnosis and knowledge of factors related to higher prevalence of neuropathy is very important for understanding and preventing the course of the disease. Thus, the hypothesis of the present study is the existence of peripheral nerve commitment in asymptomatic diabetic patients for neuropathy and that this change is related to sedentary lifestyle, hypertension, high glycemic index and smoking.Objectives:a) to evaluate the prevalence of male and female diabetics; b) to evaluate the prevalence of peripheral nervous system injury in asymptomatic type II diabetic patients for neuropathy; c) demonstrate the relevance of clinical history, neurological and electroneuromyographic examination for early diagnosis; and d) Correlate behavioral and biochemical factors with the occurrence of peripheral neuropathy.Methods:A total of 365 type II diabetic patients participated in the study. Through the exclusion criteria, 184 asymptomatic diabetics for neuropathy were selected. Data collection was performed in a single step, including directed anamnesis, clinical and neurological examination: including adapted Michigan scale, esthesiometry and electroneuromyography. The sural nerve was analyzed for latency, amplitude and velocity of the compound muscle action potential. In addition, neural injury was related or not to variables:

gender, age, diabetes time, physical activity, smoking, hypertension, fasting glucose, HDL- cholesterol, creatinine and triglycerides. To measure the impact of the variables an univariate

analysis was performed via logistic regression, implementing the Stewise method (Bacward and Forward). Bivariate analyzes and sequential logistic regression model were performed aiming at a significance level of less than 5% (p<0.05)Results:observed a high prevalence (68.22%) of female diabetic patients. In addition, it was also observed that 39.23% of asymptomatic diabetic patients for neuropathy already had altered electrical impulse conduction in the peripheral nerve, that is, asymptomatic diabetic patients already have subclinical neuropathy and that this neuropathy is related to high glycemic index, smoking, hypertension, age and sedentary lifestyle. Conclusion:The prevalence of peripheral neuropathy in asymptomatic type II diabetics is significant and is related to lifestyle (sedentary lifestyle), comorbidities (hypertension), smoking, lack of adequate glycemic control and age. The promotion of a public policy and awareness of early diagnosis has great relevance to avoid the great morbidity and mortality of this disease. Neurographic study has predictive value in distal and symmetrical diabetic polyneuropathy in asymptomatic individuals.