Diabetic Peripheral Neuropathy: A Clinical Study Correlating Peripheral Neuropathy with Dyslipidemia and Nerve Conduction Velocity Study in Diabetics.

Introduction: Diabetic peripheral neuropathy (DPN) is one of the most common and debilitating complications of diabetes mellitus, affecting approximately 50% of patients with long-standing disease. While hyperglycemia is the primary driver of nerve damage, emerging evidence suggests that dyslipidemia may also contribute significantly to the development and progression of neuropathy. This study aimed to evaluate the clinical profile, lipid abnormalities, and nerve conduction patterns in patients with DPN and to explore the potential correlations between these parameters.

Methodology: This cross-sectional study included 100 diabetic patients with clinical evidence of peripheral neuropathy. Comprehensive assessment included demographic data, diabetes history, clinical examination, metabolic parameters (fasting and postprandial blood glucose, glycated hemoglobin [HbA1c], and complete lipid profile), and nerve conduction studies of upper and lower limb nerves. Neuropathy was classified as motor, sensory, or sensorimotor based on clinical and electrophysiological findings, and severity was assessed using the Toronto Clinical Neuropathy Scale.

Results: The study population had a slight female predominance (54%) and uniform distribution across age groups. Type 2 diabetes constituted 88% of cases, with diabetes duration ranging from <5 to 20 years. Metabolic assessment revealed poor glycemic control in most patients (99% with fasting blood sugar >126 mg/dL, 100% with postprandial blood sugar >180 mg/dL, and 84% with HbA1c >7%) and high prevalence of lipid abnormalities (88% with hypertriglyceridemia and 90% with elevated low-density lipoprotein-cholesterol). Sensory symptoms (numbness 71% and tingling 62%) predominated over motor symptoms. Sensory neuropathy was the most common type (45%), followed by sensorimotor (32%) and motor neuropathy (23%). Nerve conduction studies showed greater involvement of sensory nerves, with upper limb nerves (median and ulnar) being more frequently affected than lower limb nerves. No statistically significant associations were found between lipid parameters and neuropathy types or severity, although trends were observed.

Conclusion: This study demonstrates a high prevalence of dyslipidemia and poor glycemic control in patients with DPN, with sensory neuropathy being the predominant type. While statistical associations between specific lipid abnormalities and neuropathy characteristics were not established, the remarkably high prevalence of lipid derangements suggests that they may contribute to the pathogenesis. A multifactorial approach to neuropathy management, addressing both glycemic control and lipid abnormalities, may be beneficial in reducing the burden of this complication.