Keywords
Diabetic polyneuropathy
Obesity
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Abstract
Objective: To investigate the prevalence of PNDS (symmetrical distal polyneuropathy) and/or neuropathic pain among individuals with obesity and metabolic factors. Methods: Cross-sectional, descriptive, observational study, carried out in a public hospital in the Federal District. Individuals with BMI ≥ 30 kg/m², ≥ 18 years old were included. Tests for the diagnosis of PNDS were performed using an application. Results: The pilot study involved 31 participants, mean age 44.19 (±12.88), 27 women (87.1%), BMI 42.44 (±5.89), 22 (71%) with pre-DM or DM. The presence of PNDS is significantly independent in older individuals, with longer obesity, presence of pre-DM or DM2, use of statins and with higher scores (8 versus 6) on the Visual Analog Scale (VAS) for ache. Conclusion: An association of PNDS and obesity was found in older individuals with longer disease duration, pre-DM or DM2, under treatment for dyslipidemia and with a higher score for neuropathic pain on the VAS. In addition, the study alerts, for the first time in our country, to the need for screening for PNDS in people with obesity, even without changes in blood glucose.
References
ABBOTT CA, et al. Prevalence and Characteristics of Painful Diabetic Neuropathy in a Large Community-Based Diabetic Population in the UK. Diabetes Care, 2011; 34(10): 2220-2224.
ALBERS JW e POP-BUSUI R. Diabetic Neuropathy: Mechanisms, Emerging Treatments, and Subtypes. Current Neurology and Neuroscience Reports, 2014; 14(8): 473.
ANDERSEN ST, et al. Risk Factors for Incident Diabetic Polyneuropathy in a Cohort With Screen-Detected Type 2 Diabetes Followed for 13 Years: ADDITION-Denmark. Diabetes Care, 2018; 41(5): 1068-1075.
ANDERSON JL, et al. Do Statins Increase the Risk of Idiopathic Polyneuropathy? The American Journal of Cardiology, 2005; 95(9): 1097-1099.
CALLAGHAN BC, et al. Diabetic neuropathy: what does the future hold? Diabetologia, 2020; 63(5): 891-897.
CALLAGHAN BC, et al. Distal Symmetric Polyneuropathy. JAMA, 2015; 314(20): 2172.
CALLAGHAN BC, et al. Metabolic Syndrome Components Are Associated With Symptomatic Polyneuropathy Independent of Glycemic Status. Diabetes Care, 2016; 39(5): 801-807.
CALLAGHAN BC, et al. Better diagnostic accuracy of neuropathy in obesity: A new challenge for neurologists. Clinical Neurophysiology, 2018; 129(3): 654-662.
CALLAGHAN BC e FELDMAN EL. The metabolic syndrome and neuropathy: Therapeutic challenges and opportunities. Annals of Neurology, 2013; 74(3): 397-403.
CARMICHAEL J, et al. Advances in Screening, Early Diagnosis and Accurate Staging of Diabetic Neuropathy. Frontiers in Endocrinology, 2021; 12.
FELDMAN EL, et al. Diabetic neuropathy. Nature Reviews Disease Primers, 2019; 5(1): 41.
GAIST D, et al. Statins and risk of polyneuropathy: A case-control study. Neurology, 2002; 58(9): 1333-1337.
GREGG EW, et al. Prevalence of Lower-Extremity Disease in the U.S. Adult Population ≥40 Years of Age With and Without Diabetes. Diabetes Care, 2004; 27(7): 1591-1597.
GRISOLD A, et al. Mediators of diabetic neuropathy. Current Opinion in Endocrinology & Diabetes and Obesity, 2017; 24(2): 103-111.
BRANSPEDI, 2019. Sistema brasileiro para avaliação de risco de ulceração em pés diabéticos. Disponível em: htpp://www.sistemabranspedi.com.br. Acessado em: 10 de fevereiro de 2022.
JENSEN TS, et al. Painful and non-painful diabetic neuropathy, diagnostic challenges and implications for future management. Brain, 2021; 144(6): 1632-1645.
BRASIL. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico- VIGITEL. Ministério da Saúde. 2021. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/publicacoes-svs/vigitel/vigitel-brasil-2021-estimativas-sobre-frequencia-e-distribuicao-sociodemografica-de-fatores-de-risco-e-protecao-para-doencas-cronicas/. Acessado em: 20 de outubro de 2022.
MOREIRA RO, et al. Tradução para o português e avaliação da confiabilidade de uma escala para diagnóstico da polineuropatia distal diabética. Arquivos Brasileiros de Endocrinologia & Metabologia, 2005; 49(6): 944-950.
PEDROSA H, et al. Neuropatias e Pé Diabético. 2 ed. São Paulo: AC Farmacêutica – Grupo Editorial Nacional, 2013; 229-243p.
POP-BUSUI R, et al. Diagnosis and Treatment of Painful Diabetic Peripheral Neuropathy. ADA Clinical Compendia, 2022; 2022(1): 1-32.
POP-BUSUI R, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care, 2017; 40(1): 136-154.
RODACKI M, et al. Classificação do diabetes. In Diretriz Oficial da Sociedade Brasileira de Diabetes. Conectando Pessoas, 2022.
SASAKI H, et al. Spectrum of diabetic neuropathies. Diabetology International, 2020; 11(2): 87-96.
TESFAYE S, et al. Vascular Risk Factors and Diabetic Neuropathy. New England Journal of Medicine, 2005; 352(4): 341-350.
WIGGIN TD, et al. Elevated Triglycerides Correlate With Progression of Diabetic Neuropathy. Diabetes, 2009; 58(7): 1634-1640.
ZHOU Z, et al. Glycemic variability: adverse clinical outcomes and how to improve it? Cardiovascular Diabetology, 2020; 19(1): 102.