Prevalence and concomitance of diabetic peripheral sensory neuropathy and lower limb peripheral arterial disease in type II diabetics and its correlation with obesity.

Abstract

Introduction: Among type 2 diabetics (T2D), macrovascular complication lower limb Peripheral Arterial Disease (PAD) and microvascular complication Diabetic Peripheral Sensory Neuropathy (DPSN) have scarcely studied concordance and their association with obesity. Qualitative and general body fat parameters give a complete picture of obesity. We studied the association of vibration perception threshold (VPT)-based DSPN and ankle brachial pressure index (ABPI))-based PAD, and the effect of obesity on them, in T2Ds.

Methods: A cross-sectional study was done on 152 under-treatment T2Ds. Bio-esthesiometer-based VPT from the sole of each foot and VersaDop-based ABPI from all limbs were assessed. Prevalence of DSPN (VPT ≥25) and PAD (ABPI ≤0.9) was measured and compared for concomitance. The odds ratio was used for testing association and multiple linear regressions were accomplished for predictors of VPT and ABPI taking P value < 0.05 as statistically significant.

Results: T2Ds had a mean age of 53 years, a mean duration of 67 months, and 48% glycemic control. The prevalence of abnormal VPT and ABPI was 64% and 23%, respectively. VPT-based subgroups do not defer significantly from ABPI and vice versa. Obesity was associated with only abnormal ABPI (visceral > general). Odd's ratio for neuropathy with vasculopathy was insignificant while VPT and ABPI had differences in significant predictors.

Conclusion: T2Ds having 64% neuropathy and 23% vasculopathy had one-third concomitance but lack of association and different predictors for each. Vasculopathy not neuropathy was associated with obesity; visceral more than general; suggesting scope for its rectification. It suggests different progression of these complications, despite some cross-talk between them.