Distal Symmetric and Cardiovascular Autonomic Neuropathies in Brazilian Individuals with Type 2 Diabetes Followed in a Primary Health Care Unit: A Cross-Sectional Study

• Main Authors: Mozania Reis de Matos, Daniele Pereira Santos-Bezerra, Cristiane das Graças Dias Cavalcante, Jacira Xavier de Carvalho, Juliana Leite, Jose Antonio Januario Neves, Sharon Nina Admoni, Marisa Passarelli, Maria Candida Parisi, Maria Lucia Correa-Giannella
• Format: Article
• Language: English
• Published: MDPI AG 2020-05-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: diabetic neuropathy; distal symmetric polyneuropathy; primary care; cardiovascular autonomic neuropathy
• Online Access: https://www.mdpi.com/1660-4601/17/9/3232

The paucity of epidemiological data regarding diabetes complications in Brazil motivated us to evaluate the prevalence rates of distal symmetric polyneuropathy (DSP) and of cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes (T2D) followed in a primary care unit. A total of 551 individuals (59.3% women, 65 years old; diabetes duration of 10 years; HbA1c of 7.2%, medians) were included in this cross-sectional study. DSP was diagnosed by sum of the Neuropathy Symptoms Score (NSS) and Modified Neuropathy Disability Score (NDS) and by the Semmes–Weinstein monofilament. CAN was diagnosed by cardiovascular autonomic reflex tests combined with spectral analysis of heart rate variability. The prevalence rates of DSP were 6.3% and 14.3%, as evaluated by the sum of NSS and NDS and by the Semmes–Weinstein monofilament, respectively. Those with DSP diagnosed by monofilament presented longer diabetes duration, worse glycemic control and a higher stature. The prevalence rates of incipient and definitive CAN were 12.5% and 10%, respectively. Individuals with definitive CAN presented a higher frequency of hypercholesterolemia and of arterial hypertension. The higher prevalence rate of DSP with the use of the monofilament suggests that it may be a more appropriate tool to diagnose DSP in the primary care setting in Brazil.