Peripheral Neuropathy Increases The Difficulty Of Blood Pressure Management In Patients With Type 2 Diabetes Mellitus

Objective: Previous studies have shown that Diabetic Peripheral Neuropathy(DPN)has a higher blood pressure level than patients with non-Diabetic Peripheral Neuropathy(N-DPN),and our study is to understand diabetic peripheral neuropathy DPN)and its severity and blood pressure,to explore whether diabetic peripheral neuropathy(DPN)increased the difficulty of blood pressure management in patients with type 2 diabetes.Method: This study was a retrospective survey involving 3710 patients with type 2diabetes who were diagnosed with endocrinology between 30 and 90 years of age in the First Affiliated Hospital of Fujian Medical University from October 2008 to December2016.From 2530 patients Hypertension(Hypertension,HT)(DPN / non-DPN =1332/1198)and 1180 non-Hypertension(N-HT)(DPN / non-DPN = 554/626).All participants received standardized medical history collection,physical examination,biochemical tests,including special neurological symptoms(such as limb numbness,pain,paresthesia,fatigue,walking instability,etc.)and peripheral neuropathy signs(including pain,Sensory,temperature sensation,tuning fork vibration sensation,positional sensation,bilateral ankle knee reflexes),of which 1776 patients were sensory and motor nerve conduction velocity measurements by electromyography.According to the classification criteria of Toronto Clinical Neuropathy Scoring System(TCSS),DPN(non-DPN),mild DPN(Mild),moderate DPN(Moderate),severe DPN(Severe)The Nerve conduction velocity(NCV)was calculated by Dyck method and divided into quadruple group(P ?25%-P>75%).The logistic regression of the sample was analyzed by using SPSS 18.0 statistical software,and the logistic regression analysis was used to analyze the severity of DPN and the velocity of composite nerve and the blood pressure of hypertensive patients and the normal blood pressure of non-hypertensive patients Rate of relationship.Results:1.Compared with non-DPN group,DPN group had lower blood pressure target rate(28.8% vs 38.9%,P <0.05)in hypertensive patients.Compared with non-DPN group,the blood pressure target rate of moderate and severe DPN group decreased,and there was no significant difference in mild group,OR(95%CI)values were 0.586(0.457-0.751),0.439(0.266-0.725),0.820(0.574-1.170).Compared with the P ?25%group,the achieve blood pressure goals P>75% group decreased,P25%-50% and P50%-75%had no difference(P <0.05),OR(95% CI)were 0.487(0.318-0.744),0.906(0.626-1.310),0.735(0.500-1.081).2.In non-hypertensive patients,DPP group had lower blood pressure compliance rate(29.1% vs 38.9%,P <0.05)than non-DPN group.After correcting the confounding factors,Compared with non-DPN group,the normal blood pressure of moderate and severe DPN group decreased(P <0.05),OR(95% CI)values were 0.417(0.249-0.696),0.268(0.109-0.657)0.853(0.603-1.029).compared with the nerve conduction velocity P?25%,P50%-50%,P50%-75% and P> 75% normal blood pressure were decreased(P <0.05),OR(95% CI)values were 0.370(0.215-0.636),0.319(0.180-0.567),0.260(0.138-0.448).Conclusions:DPN and its severity were associated with a decrease in blood pressure compliance and a decrease in the detection of normal blood pressure in hypertensive patients.The presence of DPN not only increases the difficulty of managing hypertension,but also increases the level of blood pressure in non-hypertensive patients.