Vijayananth P¹, Anbarasi M², Hemadharshini S³, Tharun S³
¹Department of Medicine, ²Department of Physiology & ³Final Year MBBS Students, Dhanalakshmi Srinivasan Medical College Hospital (The Tamil Nadu Dr.MGR Medical University), Perambalur, Tamil Nadu, India

Abstract

• Background: Diabetes is a metabolic disorder wherein the ensuing complications contribute to the morbidity and mortality to a major extent. According to the ticking-clock hypothesis, macrovascular complications like cardiovascular problems develop in the pre-diabetic stage in type 2 diabetes whereas microvascular complications are slower to develop. Recent studies suggest that besides hyperglycemia, many other vascular risk factors are also involved in the aetiology of neuropathy.
• Aim: This study aimed to predict the risk of developing neuropathy from the cardiovascular risk factors in patients with type 2 diabetes.
• Materials and Methods: This cross-sectional study was carried out at Dhanalakshmi Srinivasan Medical College Hospital, Perambalur. 102 biochemically proven type 2 diabetic patients, were included in the study by convenient sampling technique following specific inclusion and exclusion criteria. Data on demographics, duration of diabetes,nature of treatment and family history were collected; blood pressure was recorded in the dominant arm and the subjects were subjected to fasting and post-prandial blood sugars and lipid profile estimations. Neurological examination was performed to assess the risk of neuropathy using Michigan Neuropathy Screening Instrument (MNSI). Using the patient’s examination and investigation reports, the cardiovascular risk scores were computed by Framingham Heart Risk Score. Correlation was sought between the MNSI symptom and sign scores and FHRS using Spearman Rank Correlation Test.
• Results: While the symptom scores of MNSI did not significantly correlate with the FHRS (r=0.04; p=0.64), the MNSI sign scores showed a significant positive correlation with the latter correlation (r=0.197; p=0.04), the correlation coefficient however was weak.
• Conclusion: As this study showed only very weak correlation between the aggregated cardiovascular risk scores,it is not conclusive to be used as a marker for assessing the risk of neuropathy at the earliest stage in diabetes, even when other risk factors namely, duration of diabetes, glycaemic status, BMI, hypertension and lipid profile were inconclusively associated.

Keywords: microvascular, neuropathy, type 2 diabetes mellitus