Heterogeneidade clínica e coexistência das neuropatias diabéticas: diferenças e semelhanças entre diabetes melito tipos 1 e 2

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Data
2009-10-01
Autores
Rolim, Luiz Clemente de Souza Pereira [UNIFESP]
Sá, João Roberto de [UNIFESP]
Chacra, Antonio Roberto [UNIFESP]
Dib, Sergio Atala [UNIFESP]
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Objective: To evaluate the heterogeneity and the coexistence of diabetic neuropathy (DNP) in type 1 (T1DM) and 2 (T2DM) diabetes mellitus. Methods: 74 T2DM and 20 T1DM patients were evaluated according to age (years), time from diagnosis of diabetes (TDD, years), body mass index (BMI, kg/m(2)), HbA1c and DNP type (American Diabetes Association criteria). Results: T1DM was younger (32.7 +/- 11.0 versus 56.9 +/- 10.3; p = 0.0001), leaner (BM: 23.6 +/- 3.85 versus 28.4 +/- 5.3; p = 0.0005) and they had longer TDD (171 +/- 9.7 versus 10.4 +/- 6.8; p = 0.003). Cardiovascular autonomic neuropathy (CAN) (60% versus 32.4%; p = 0.02) and its coexistence with polyneuropathy (PN) (62.5% versus 33.3%; p = 0.03) were more common in T1DM. Chronic painful polyneuropathy (CPP) was more prevalent in T2DM (60.8% versus 30.0%; p = 0.009). Logistic regression showed HbA1c as an independent variable related to PN (p = 0.04) in both groups. TDD (p = 0.03) and CPP (p = 0.003) were related to CAN in T1DM. Age (p = 0.0004) was related to CPP in T2DM. Conclusions: The DNP have shown a heterogeneity distribution in type 1 and type 2 diabetes mellitus. The related factors to different phenotypes of this complication, apart from hyperglycemia, may be variable between these two types of diabetes mellitus. Arq Bras Endocrinol Metalb. 2009;53(7):818-24
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Arquivos Brasileiros De Endocrinologia E Metabologia. Rio De Janeiro, Rj: Sbem-soc Brasil Endocrinologia & Metabologia, v. 53, n. 7, p. 818-824, 2009.
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