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Peripheral Neuropathy Associated with CV Disease and Stroke in Type 2 Diabetes Patients

Testing for peripheral neuropathy may provide a way to identify individuals at higher risk of cardiovascular events…. 

Jack Brownrigg, a PhD student at St George’s, University of London, UK, who conducted the research at St George’s Vascular Institute, said, "While the risk of cardiovascular disease is known to be higher in patients with diabetes, predicting which patients may be at greatest risk is often difficult.

"We looked at data on individuals with no history of cardiovascular disease and found that those with peripheral neuropathy were more likely to develop cardiovascular disease."

Robert Hinchliffe, Senior Lecturer and Consultant in Vascular Surgery at St George’s who co-led the study with Professor Kausik Ray, said: "While loss of sensation in the feet is known to be a key risk factor for foot ulcers, it may also provide additional useful information to guide patient management. This is the first study to show that it can also indicate an increased risk of cardiovascular problems like heart attacks or strokes.

"The good news is that peripheral neuropathy can be easily identified by simple tests carried out in GP surgeries. The results of the study warrant further investigation as to whether even greater control of risk factors including blood pressure and blood sugar can prevent or delay the onset of cardiovascular disease.

"There is likely an unmet potential to reduce cardiovascular disease in this group of patients through greater monitoring and simple treatments."

The researchers analyzed data from 13,000 patients diagnosed with type 2 diabetes with no history of cardiovascular diseases. They found that individuals with peripheral neuropathy were more likely to develop cardiovascular disease, noticing that patients who experienced loss of sensation in their feet also tended to have heart and circulation problems, and so, they suggested that the presence of peripheral neuropathy could be used as a simple way to indicate which high-risk patients with diabetes are in need of intensive care and monitoring.

Practice Pearls:
  • Patients with diabetes are at higher risk of developing cardiovascular disease and strokes.
  • Predicting which patients are at higher risk of developing cardiovascular disease is very difficult.
  • Patients with peripheral neuropathy are at a greater risk of developing heart and circulation problems, and therefore, peripheral neuropathy could be used as a way of identifying patients who are at high risk of cardiovascular disease.
Press Release, St. George’s, University of London

Peripheral neuropathy and the risk of cardiovascular events in type 2 diabetes mellitus. Heart doi:10.1136/heartjnl-2014-305657, http://heart.bmj.com/content/early/2014/08/05/heartjnl-2014-305657.abstract?sid=966c34dc-ea1f-4bc4-8547-d0dd61d23850