Diabetic polyneuropathy in the elderly

Prevalence and risk factors in two geographic areas of Italy

Authors

  • E. Beghi,

    Corresponding author
    1. Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, and Clinica Neurologies, Ospedale “San Gerardo”, Monza, Italy
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  • M. L. Monticelli,

    1. Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, and Clinica Neurologies, Ospedale “San Gerardo”, Monza, Italy
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  • the Italian General Practitioner Study Group (IGPSG)

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    • *

      Principal investigators: E. Beghi and M. L. Monticelli; members: L. Amoruso, F. Apollo, M. L. Delodovici, G. Grampa, D. Porazzi, M. Perini, E Simone, P Tonali, M. Zarrelli (Neurologists); D. Bombelli, M. G. Bombelli, F. Canistro, M. Capuano, D. Castiglioni, A. Ciani, M. Cursio, M. Danza, V. Ferrari, S. Galli, T. Gandini, D. Giussani, R. Luoni, A. Melchionda, G. Molenda, E. Motta, M. Passamonti, R. Picotti, R. Pericoli, M. Pigni, D. Ponti, M. Puricelli, A. Sessa, D. Sinapi, G. Taramelli, M. G. Venosta, R. Zuccoli (General Practitioners).


Dr Ettore Beghi, Istituto di Ricerche Farmacologiche “Mario Negri”, Via Eritrea 62, 20157 Milan, Italy

Abstract

Objective - To assess the prevalence and the risk factors of diabetic polyneuropathy in representative samples of elderly individuals. Patients - 4191 subjects 55 years and older from two areas of Italy were screened by their general practitioners (GPs) and those positive for neuropathic symptoms were subjected to a standard clinical examination. Methods - The screening questionnaire included a list of clinical conditions possibly causing polyneuropathy, including diabetes. In patients with diabetes, the date of diagnosis, the most recent fasting and post-prandial blood glucose value and glycosylated hemoglobin were sought. Probable polyneuropathy was diagnosed through impairment of 2 or 3 nerve functions (strength, sensation, tendon reflexes) in the extremities with symmetrical and distal distribution. Results - The sample included 347 patients with diabetes (8.3%). Sixty-six of them (19%) had symptoms and signs consistent with probable polyneuropathy (overall prevalence 1.6%). The disease prevailed in women and in subjects aged 75 years and older. Diabetic patients with polyneuropathy had a longer disease course (P<0.02) and high mean fasting (P<0.001) and post-prandial (P<0.02) blood glucose. Conclusion - Diabetic polyneuropathy in the elderly is a fairly common clinical condition prevailing in women and in subjects 75 years and older. Risk factors for polyneuropathy include prolonged disease duration and high mean fasting and post-prandial blood glucose.

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