Coppini, D. V., Spruce, M.C., Thomas, P. and Masding, M.G., 2006. Established diabetic neuropathy seems irreversible despite improvements in metabolic and vascular risk markers—a retrospective case–control study in a hospital patient cohort. Diabetic Medicine, 23 (9), pp. 1016-1020.
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Aims To gain insight into the natural history of diabetic peripheral neuropathy (DPN) and its risk factors by means of sequential quantitative testing in a hospital patient cohort. Methods A retrospective case–control study involving 300 diabetic patients (100 subjects with neuropathy and 200 control subjects) attending Poole Hospital diabetes clinic between 1995 and 2002. All subjects had a detailed annual clinic assessment including vibration perception threshold (VPT) and physical and metabolic assessments and were categorized according to neuropathy status. Established neuropathy was defined as a VPT > 25 V. Cross-sectional data were analysed by means of a t -test and longitudinal data by means of ANOVA . Results VPTs increased over time in neuropathy patients, with no change in control patients ( P < 0.001). Glycaemic control was better over that period in control patients but the rate of improvement in HbA 1c over time was similar in both groups. Triglyceride and high-density lipoprotein cholesterol levels improved in both groups, with significantly greater change in the control group. Conclusions Data on reversibility of neuropathy are scarce and our 8-year series shows a continual deterioration in VPT in patients with a threshold > 25 V despite modest improvements in glycaemic control and lipid parameters. This work also supports a vascular association with neuropathy and identifies neuropathic patients as a high-risk cardiovascular group in whom, despite little influence on neuropathy itself, the above metabolic factors should be actively addressed.
|Subjects:||Technology > Medicine and Health|
|Group:||School of Health and Social Care > Centre for Social Work and Social Policy|
|Deposited By:||INVALID USER|
|Deposited On:||03 Sep 2008 16:18|
|Last Modified:||07 Mar 2013 14:50|
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