Predictive factors for diabetic neuropathy in older people treated in primary care
DOI:
https://doi.org/10.12707/RV20148Keywords:
elderly, diabetic neuropathies, primary health care, depressionAbstract
Background: Diabetic neuropathy (DN) is a complication that affects patients with Diabetes Mellitus (DM), a chronic disease with high prevalence among older people.
Objective: To assess the predictive factors for diabetic neuropathy in older people treated in primary care.
Methodology: Cross-sectional study with 111 older people with type 2 DM. A biochemical analysis was performed, and the Beck Depression Inventory, the Visual Numeric Scale, and the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale were used. The regression analysis was performed using IBM SPSS Statistics, version 20.0.
Results: The prevalence of DN was 29.7%. Pain intensity in the feet and calves was significantly associated with DN (p = 0.001). The following factors were significantly associated with DN: glycated hemoglobin (p < 0.001), fasting blood sugar level (p = 0.001), triglycerides (p = 0.038), depression (p < 0.001), and a sedentary lifestyle (p < 0.001). After logistic regression, high glycated hemoglobin, a sedentary lifestyle, and depression remained associated with DN.
Conclusion: The predictive factors for DN in older people were depression, high glycated hemoglobin, and a sedentary lifestyle.
Downloads
References
Aguiar, F. L., Ramos, L. F., & Bichara, C. N. (2018). Deteccao de dor com caracteristicas neuropaticas em pacientes com diabetes mellitus atendidos na atencao basica. Brazilian Journal of Pain, 1(1), 15-20. https://doi.org/10.5935/2595-0118.20180005
Bai, J. W., Lovblom, L. E., Cardinez, M., Weisman, A., Farooqi,M. A., Halpern, E. M., Boulet, G., Eldelekli, D., Lovshin, J. A., Lytvyn, Y., Keenan, H. A., Brent, M. H., Paul, N., Bril, V., Cherney, D. Z., & Perkins, B. A. (2017). Neuropathy and presence of emotional distress and depression in longstanding diabetes: Results from the Canadian study of longevity in type 1 diabetes. Journal of Diabetes Complications, 31(8), 1318-1324. https://doi.org/10.1016/j.jdiacomp.2017.05.002
Brinati, L. M., Diogo, N. A., & Moreira, T. R. (2017). Prevalencia e fatores associados a neuropatia periferica em individuos com diabetes mellitus. Revista Cuidado é Fundamental, 9(2), 347-355. http://dx.doi.org/10.9789/2175-5361.2017.v9i2.347-355
D’Amato, C., Morganti, R., Greco, C., Di Gennaro, F., Cacciotti, L., Longo, S., Mataluni, G., Lauro, D., Marfia, G. A., & Spallone, V. (2016). Diabetic peripheral neuropathic pain is a stronger predictor of depression than other diabetic complications and comorbidities. Diabetes & Vascular Disease Research, 13(6), 418-428. https://doi.org/10.1177 /1479164116653240
Diretrizes da Sociedade Brasileira de Diabetes. (2019). Diretrizes da Sociedade Brasileira de Diabetes - 2019-2020. Editora Clannad. http://www.saude.ba.gov.br/wp-content/uploads/2020/02/Diretrizes-Sociedade-Brasileira-de-Diabetes-2019-2020.pdf
Faludi, A. A., Izar, M. C., Saraiva, J. F., Chacra, A. P., Bianco, H. T., Afiune Neto, A., Bertolami, A., Pereira, A. C., Lottenberg, A. M., Sposito, A. C., Chagas, A. C., Casella Filho, A., Simao, A. F., Alencar Filho, A. C., Caramelli, B., Magalhaes, C. C. Negrao, C. E., Ferreira, C. E., Scherr, C., Feio, C. M. A., Kovacs, C., Araujo, D. B., Calderaro, D. , Gualandro, D. M. , Mello Junior, E. P., Alexandre, E. R. G., Sato, I. E., Moriguchi, E. H., Rached, F. H. , Santos, F. C., Cesena, F. H. Y., FonsecA, F. A. H., Fonseca, H. A. R., Xavier, H. T., Pimentel, I. C., Giuliano, I. C. B., Issa, J. S. , Diament, J., Pesquero, J. B., Santos, J. E., Faria Neto, J. R., Melo Filho, J. X., Kato, J. T., Torres, K. P., Bertolami, M. C., V, M. H. A., Miname, M. H., Scartezini, M., Forti, N. A., Coelho, O. R., Maranhao, R. C. , Santos Filho, R. D. , Alves, R. J., Cassani, R. L., BettI, R. T. B., Carvalho, T., Martinez, T. L. R., Giraldez, V. Z. R. & Salgado Filho, W. (2019). Atualizacao da Diretriz Brasileira de Dislipidemias e Prevencao da Aterosclerose - 2017. Arquivos Brasileiros de Cardiologia, 109(Suppl1), 1–76. https://doi.org/10.5935/abc.20170121
Garoushi, S., Johnson, M. I., & Tashani, O. A. (2019). A cross-sectional study to estimate the point prevalence of painful diabetic neuropathy in Eastern Libya. BMC Public Health, 19(1), 78. https://doi.org/10.1186/s12889-018-6374-9
Gomes, H. G., Bittencourt, F. S., Costa, C. C., & Ferreira, J. M. S. (2018). Prevalencia e perfil dos pacientes com neuropatia periferica diabetica acompanhados por uma unidade de saude. Revista Interdisciplinar, 11(2), 47-55. http://dx.doi.org/10.17648%2F2317-5079.v11n2.1429
Gomes-Oliveira, M. H., Gorenstein, C., Neto, F. L., Andrade, L. H., & Wang, Y. P. (2012). Validacao da versao Brasileira em Portugues do Inventario de Depressao de Beck-II numa amostra da comunidade. Revista Brasileira de Psiquiatria, 34(4), 389–94. https://doi.org/10.1016/j.rbp.2012.03.005
International Diabetes Federation. (2017). Diabetes Atlas (8th ed.). https://diabetesatlas.org/upload/resources/previous/files/8/IDF_DA_8e-EN-final.pdf
Khan, P., Qayyum, N., Malik, F., Khan, T., Khan, M., & Tahir, A. (2019). Incidence of anxiety and depression among patients with type 2 diabetes and the predicting factors. Cureus, 11(3), e4254. https://doi.org/10.7759 / cureus.4254
Kirwan, J. P., Sacks, J., & Nieuwoudt, S. (2017). The essential role of exercise in the management of type 2 diabetes. Cleveland Clinic Journal of Medicine, 84(7 Suppl 1), S15–S21. https://doi.org/10.3949/ccjm.84.s1.03
Lima, L. R., Stival, M. M., Funghetto, S. S., Volpe, C. R., Rehem, T. C., Santos, W. S., & Funez, M. M. (2018). Lower quality of life, lower limb pain with neuropathic characteristics, female sex, and ineffective metabolic control are predictors of depressive symptoms in patients with type 2 diabetes mellitus treated in primary care. International Journal of Diabetes in Developing Countries, 39, 463-470. https://doi.org/10.1007/s13410-018-0667-5.
Lipschitz, D. A. (1994). Screening for nutritional status in the elderly. Primary Care, 21(1), 55-67. https://pubmed.ncbi.nlm.nih.gov/8197257/
Mejias, S. G., & Ramphul, K. (2018). Prevalence of peripheral arterial disease among diabetic patients in Santo Domingo, Dominican Republican and associated risk factors. Archives of Medical Sciences, 15(3), e35-e40. https://doi.org/10.5114/amsad.2018.73527
Melzack R., & Katz J. (1994). Pain measurement in persons (3 ed.). Churchill Livingstone.
Ministerio da Saude. (2017). Vigitel Brasil 2017: Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequencia e distribuicao sociodemografica de fatores de risco e protecao para doencas cronicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2017 / Ministerio da Saude, Secretaria de Vigilancia em Saude, Departamento de Vigilancia de Doencas e Agravos nao Transmissiveis e Promocao da Saude. – Brasilia: Ministerio da Saude, 2018. https://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2017_vigilancia_fatores_riscos.pdf
Pop-Busui, R., Ang, L., Holmes, C., Gallagher, K., & Feldman, E. L. (2016). Inflammation as a therapeutic target for diabetic neuropathies. Current Diabetes Reports, 16(3), 29. https://doi.org/10.1007 / s11892-016-0727-5
Santos, H. C., Ronsoni, M. F., Colombo, B. S., Oliveira, C. S., Hohl, A., Coral, M. H., & Sandee-Lee, S. V. (2015). Escores de neuropatia periferica em diabeticos. Revista da Sociedade Brasileira de Clínica Médica, 13(1), 40-45. http://www.sbcm.org.br/ojs3/index.php/rsbcm/article/view/114/110
Schestatsky, P., Felix-Torres, V., Chaves, M. L. Camara-Ehlers, B.. Mucenic, T., Caumo, W., Nascimento, O., & Bennett, M. I. (2011). Brazilian Portuguese validation of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) for patients with chronic pain. Pain Medicine, 12(10), 1544/1550. https://doi.org/10.1111/j.1526-4637.2011.01221.x