Cardiovascular disease predicts diabetic peripheral polyneuropathy in subjects with type 2 diabetes: A 10-year prospective study

Background: The relationship between cardiovascular disease and diabetic peripheral neuropathy is mainly sustained by data retrieved from cross-sectional studies focused on cardiovascular risk factors. We aimed to assess the presence of cardiovascular disease as a risk factor for developing diabetic peripheral neuropathy in a type 2 diabetes mellitus population. Method: A 10-year prospective, primary care, multicentre study in a randomly selected cohort. Cardiovascular disease presence included stroke, coronary artery disease and/or peripheral ischaemia. Diabetic peripheral neuropathy diagnosis was based on clinical neurological examination as well as the neuropathy symptoms score and nerve conduction studies. Results: Three hundred and ten (N=310) patients were initially recruited. Two-hundred and sixty seven (N=267) patients were included in the study. Diabetic peripheral neuropathy cumulative incidence was 18.3% (95% confidence intervals 14.1-23.4; N=49). Diabetic peripheral neuropathy development was significantly more frequent in participants presenting with cardiovascular disease at baseline (P=0.01). In the final logistic regression analysis, the presence of cardiovascular disease remained associated with an increased risk for diabetic peripheral neuropathy (odds ratio 2.32, 95% confidence intervals 1.03-5.22) in addition to diabetes duration and low density lipoprotein-cholesterol levels. Conclusions: In our series, type 2 diabetes mellitus patients with cardiovascular disease at baseline present with an increased risk of developing diabetic peripheral neuropathy at 10 years of follow-up. Our results suggest that measures aimed at the prevention, control and treatment of cardiovascular disease can also help prevent diabetic peripheral neuropathy development.