Diabetic polyneuropathy in the elderly. Prevalence and risk factors in two geographic areas of Italy. Italian General Practitioner Study Group (IGPSG).

ABSTRACT

OBJECTIVE: To assess the prevalence and the risk factors of diabetic polyneuropathy in representative samples of elderly individuals. PATIENTS 4191 subjects 55 years and older from two areas of Italy were screened by their general practitioners (GPs) and those positive for neuropathic symptoms were subjected to a standard clinical examinations. METHODS: The screening questionnaire included a list of clinical conditions possibly causing polyneuropathy, including diabetes. In patients with diabetes, the date of diagnosis, the most recent fasting and post-prandial blood glucose value and glycosylated hemoglobin were sought. Probable polyneuropathy was diagnosed through impairment of 2 or 3 nerve functions (strength, sensation, tendon reflexes) in the extremities with symmetrical and distal distribution. RESULTS: The sample included 347 patients with diabetes (8.3%). Sixty-six of them (19%) had symptoms and signs consistent with probable polyneuropathy (overall prevalence 1.6%). The disease prevailed in women and in subjects aged 75 years and older. Diabetic patients with polyneuropathy had a longer disease course (P < 0.02) and high mean fasting (P < 0.001) and post-prandial (P < 0.02) blood glucose. CONCLUSION: Diabetic polyneuropathy in the elderly is a fairly common clinical condition prevailing in women and in subjects 75 years and older. Risk factors for polyneuropathy include prolonged disease duration and high mean fasting and post-prandial blood glucose.