Pain in Patients With Type 2 Diabetes-Related Polyneuropathy Is Associated With Vascular Events and Mortality.
J Clin Endocrinol Metab
; 105(9)2020 09 01.
Article
en En
| MEDLINE
| ID: mdl-32575118
ABSTRACT
PURPOSE:
Type 2 diabetes-related polyneuropathy (DPN) is associated with increased vascular events and mortality, but determinants and outcomes of pain in DPN are poorly understood. We sought to examine the effect of neuropathic pain on vascular events and mortality in patients without DPN, DPN with pain (DPNâ +â P), and DPN without pain (DPN-P).METHODS:
A retrospective cohort study was conducted within a large health system of adult patients with type 2 diabetes from January 1, 2009 through December 31, 2016. Using an electronic algorithm, patients were classified as no DPN, DPNâ +â P, or DPN-P. Primary outcomes included number of vascular events and time to mortality. Independent associations with DPNâ +â P were evaluated using multivariable negative binomial and Cox proportional hazards regression models, adjusting for demographics, socioeconomic characteristics, and comorbidities.RESULTS:
Of 43 945 patients with type 2 diabetes (age 64.6â ±â 14.0 years; 52.1% female), 13â 910 (31.7%) had DPN 9104 DPNâ +â P (65.4%) vs 4806 DPN-P (34.6%). Vascular events occurred in 4538 (15.1%) of no DPN patients, 2401 (26.4%) DPNâ +â P, and 1006 (20.9%) DPN-P. After adjustment, DPNâ +â P remained a significant predictor of number of vascular events (incidence rate ratio [IRR] = 1.55, 95% CI, 1.29-1.85), whereas no DPN was protective (IRR = 0.70, 95% CI, 0.60-0.82), as compared to DPN-P. Compared to DPN-P, DPNâ +â P was also a significant predictor of mortality (hazard ratio = 1.42, 95% CI, 1.25-1.61).CONCLUSIONS:
Our study found a significant association between pain in DPN and an increased risk of vascular events and mortality. This observation warrants longitudinal study of the risk factors and natural history of pain in DPN.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_cardiovascular_diseases
/
6_diabetes
/
6_endocrine_disorders
Asunto principal:
Angiopatías Diabéticas
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Neuropatías Diabéticas
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Neuralgia
Tipo de estudio:
Etiology_studies
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Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2020
Tipo del documento:
Article