Risk Factors For Diabetic Peripheral Neuropathy In Type 2 Diabetes Mellitus Patients

Diabetes Mellitus (DM) is a lifetime disease which may lead to death and disability. Diabetic Peripheral Neuropathy (DPN) is one of the common complications of DM. It has closely relationship to the other complications and causes the abnormities in multi-organs. It is of value to explore and discuss the potential risk factors for the development of DPN in order to guide the preventing and treating of DPN.Objective: To identify risk factors for the development of DPN in patients with type 2 diabetes mellitus.Method: A hospital-based 1:1 pair-matched case control study was conducted in the Metabolic Disease Hospital of Tianjin Medical University during December 2002 to November 2003. Ill newly-diagnosed DPN patients and 111 DM patients without DPN were selected as case group and control group respectively. The case group subjects were matched with controls one by one on sex and age (within 5 years). All the information was collected by questionaire in face-to-face interview. Conditional logistic regression, multivariate logistic regression, principal component analysis, factor analysis and cluster analysis were used to analyse the risk factors and the potential interactions for some risk factors.Results: Results from univariate analysis showed that the following factors were significantly associated with the development of DPN: duration of DM(OR=1.912,95%CI: 1.325-2.759) , poor situation of blood sugar control (HbAlc%) (OR=2.044, 95%CI:1.163~3.592), treat with insulin (OR=2.235,95%CI:1.262~3.959), diabetic nephropathy (OR=2.000,95%CI : 1.169 ~ 3.421), diabetic retinopathy(OR=1.789,95%CI:1.021 -3.136),history of diabetic ketonemia (OR=2.000,95%CI: 1.117 -3.580),intake of flesh before diabetes mellitus (OR=8.000,95%CI:1.001 ~ 63.965),vertigo(OR=1.704,95%CI:1.087 - 2.670), dryness of skin(OR=1.712 , 95%CI:1.009-2.911), hypertension (OR=2.071, 95%CI:1.095~3.920), history of injury (OR=2.800, 95%CI:1.359 - 5.764), higher waist to hip ratio (OR=2.071, 95%CI: 1.094-3.919), higher level of blood cholesterol (Choi) (adjusted for situation of blood sugar control, OR=1.751, 95%CI:1.008-3.041),and higher level of education (OR=0.714, 95%CI:0.533~ 0.957) , intensifying the DM treatment (OR=0.775, 95%CI:0.606-0.992) , coronary heart disease (OR=0.500,95%CI:0.263~0.950) ,teadrinking( adjusted for income and level of education, OR=0.650, 95%CI: 0.425-0.993); The results of multi-logistic analysis showed that the following factors were significantly associated with DPN: duration of DM (OR=2.720,95%CI: 1.529-4.837), treat withinsulin (OR=3.824, 95% 0:1.461-10.008), vertigo(OR=2.417, 95% 0:1.212-4.820), intake of flesh before diabetes mellitus (OR=7.386,95%CI:1.037-52.510),drinking(OR=5.178, 95%CI: 1.600-16.724) and history of injury (OR=11.042, 95%CI:3.038~40.137). Besides the results mentioned above, the analysis of the interaction showed that the negative interaction existed between the following factors: duration of DM and treat with insulin; duration of DM and vertigo; duration of DM and drinking; duration of DM and history of injury; treat with insulin and vertigo; treat with insulin and drinking; treat with insulin and history of injury; vertigo and drinking; vertigo and history of injury. Conclusion: DPN relates to multiple risk factors. Longer duration of DM, treat with insulin, vertigo, more intake of flesh before diabetes mellitus, drinking, and history of injury may increase the risk of development of DPN in type 2 diabetes patients. And at the same time, the risk factors and protective factors are interrelated and interact on eachother thus influence the occurance of DPN.