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The Prevalence of Autonomic and Peripheral Neuropathy in Insulin‐treated Diabetic Sbjects
Author(s) -
Flynn M.D.,
O'Brien I.A.,
Corrall R.J.M.
Publication year - 1995
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1995.tb00483.x
Subject(s) - medicine , autonomic neuropathy , peripheral neuropathy , diabetes mellitus , peripheral , insulin , diabetic neuropathy , endocrinology , genetics , biology , cell culture , neuroblastoma
The prevalence of autonomic and peripheral neuropathy was examined in 506 diabetic sbjects treated with insulin, mean age 43 years, diabetes duration 15 (range 1–54) years. Autonomic neuropathy was present if two or more (of four) cardiovascular autonomic function tests were abnormal using age‐related ranges derived from 310 normal control sbjects. Peripheral neuropathy was defined as a vibration threshold >95th centile for age combined with absent/impaired ankle reflexes. Eighty‐four (16.6%) of diabetic sbjects had abnormal autonomic function and 119 (23.5%) peripheral neuropathy, concordant in 44/506 (8.7%). Of the diabetic sbjects with autonomic neuropathy 40/84 (47.6%) did not have peripheral neuropathy and only 44/119 (37.0%) with peripheral neuropathy had abnormal autonomic function ( p <0.001). The prevalence of both neuropathies increased in relation to diabetes duration (both p <0.001). Autonomic neuropathy was more common in sbjects diagnosed <20 years of age (18.2%) vs age >40 years (11.1%) ( p <0.05). In contrast peripheral neuropathy was more common with older age at diagnosis (<20 years 13.5% vs 36.8% >40 years, p <0.001). The age‐related prevalence of autonomic neuropathy peaked at age 40–49 years while peripheral neuropathy increased progressively with age ( p <0.001). The prevalence of peripheral exceeded autonomic neuropathy 20 years after diagnosis (40.2% vs 30.7%, p <0.001).