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Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine
BACKGROUND: Diabetic autonomic neuropathy (DAN) is a frequent complication in people with diabetes whose screening is often neglected. This study aimed to evaluate DAN through practical tools in people with diabetes in a referral center for diabetes treatment. METHODS: DAN symptoms and severity were...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130803/ https://www.ncbi.nlm.nih.gov/pubmed/37101234 http://dx.doi.org/10.1186/s13098-023-01036-7 |
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author | de Azevedo Vieira, Ana Raquel Souza Porto-Dantas, Lara Benigno do Prado Romani, Flaviene Alves Carvalho, Patrícia Souza Pop-Busui, Rodica Pedrosa, Hermelinda Cordeiro |
author_facet | de Azevedo Vieira, Ana Raquel Souza Porto-Dantas, Lara Benigno do Prado Romani, Flaviene Alves Carvalho, Patrícia Souza Pop-Busui, Rodica Pedrosa, Hermelinda Cordeiro |
author_sort | de Azevedo Vieira, Ana Raquel Souza |
collection | PubMed |
description | BACKGROUND: Diabetic autonomic neuropathy (DAN) is a frequent complication in people with diabetes whose screening is often neglected. This study aimed to evaluate DAN through practical tools in people with diabetes in a referral center for diabetes treatment. METHODS: DAN symptoms and severity were assessed using the Survey of Autonomic Symptoms (SAS) via digital application (app) in patients attended from June 1, 2021, to November 12, 2021. SAS scoring for DAN was performed using established validated cutoffs. The adhesive with cobalt salt color indicator (Neuropad™) was used as a measure of sudomotor dysfunction. Demographical and clinical data were also collected. RESULTS: Data from 109 participants, 66.9% T2DM, 73.4% female, with a median age of 54.00 (± 20.00) years, were analyzed. Symptomatic DAN was present in 69.7% of participants and was associated with older age (p = 0.002), higher HbA1c (p = 0.043), higher abdominal circumference (p = 0.019), higher BMI (p = 0.013), more likely to have metabolic syndrome (MS) with a 10-fold increased risk, and more frequent association with diabetic peripheral neuropathy (p = 0.005). Sudomotor dysfunction was found in 65 participants with positive Neuropad™ detected in 63.1% of them. CONCLUSION: The use of SAS through an app proved to be a practical and easy-to-use instrument to document symptoms of DAN in busy clinical practice. The high frequency of symptoms draws attention to the importance of screening this underdiagnosed diabetes complication. The risk factors and comorbidities associated with symptomatic DAN highlight the patients’ phenotypes linked to MS that should be targeted for DAN evaluations in larger samples in the community. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13098-023-01036-7. |
format | Online Article Text |
id | pubmed-10130803 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101308032023-04-27 Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine de Azevedo Vieira, Ana Raquel Souza Porto-Dantas, Lara Benigno do Prado Romani, Flaviene Alves Carvalho, Patrícia Souza Pop-Busui, Rodica Pedrosa, Hermelinda Cordeiro Diabetol Metab Syndr Research BACKGROUND: Diabetic autonomic neuropathy (DAN) is a frequent complication in people with diabetes whose screening is often neglected. This study aimed to evaluate DAN through practical tools in people with diabetes in a referral center for diabetes treatment. METHODS: DAN symptoms and severity were assessed using the Survey of Autonomic Symptoms (SAS) via digital application (app) in patients attended from June 1, 2021, to November 12, 2021. SAS scoring for DAN was performed using established validated cutoffs. The adhesive with cobalt salt color indicator (Neuropad™) was used as a measure of sudomotor dysfunction. Demographical and clinical data were also collected. RESULTS: Data from 109 participants, 66.9% T2DM, 73.4% female, with a median age of 54.00 (± 20.00) years, were analyzed. Symptomatic DAN was present in 69.7% of participants and was associated with older age (p = 0.002), higher HbA1c (p = 0.043), higher abdominal circumference (p = 0.019), higher BMI (p = 0.013), more likely to have metabolic syndrome (MS) with a 10-fold increased risk, and more frequent association with diabetic peripheral neuropathy (p = 0.005). Sudomotor dysfunction was found in 65 participants with positive Neuropad™ detected in 63.1% of them. CONCLUSION: The use of SAS through an app proved to be a practical and easy-to-use instrument to document symptoms of DAN in busy clinical practice. The high frequency of symptoms draws attention to the importance of screening this underdiagnosed diabetes complication. The risk factors and comorbidities associated with symptomatic DAN highlight the patients’ phenotypes linked to MS that should be targeted for DAN evaluations in larger samples in the community. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13098-023-01036-7. BioMed Central 2023-04-26 /pmc/articles/PMC10130803/ /pubmed/37101234 http://dx.doi.org/10.1186/s13098-023-01036-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research de Azevedo Vieira, Ana Raquel Souza Porto-Dantas, Lara Benigno do Prado Romani, Flaviene Alves Carvalho, Patrícia Souza Pop-Busui, Rodica Pedrosa, Hermelinda Cordeiro Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine |
title | Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine |
title_full | Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine |
title_fullStr | Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine |
title_full_unstemmed | Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine |
title_short | Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine |
title_sort | autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130803/ https://www.ncbi.nlm.nih.gov/pubmed/37101234 http://dx.doi.org/10.1186/s13098-023-01036-7 |
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