Gastrointestinal symptom burden in diabetic autonomic and peripheral neuropathy – A Danes cohort study
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Objective: We investigated associations between gastrointestinal symptoms - evaluated as a combined weighted symptom score (CWSS) – Diabetic autonomic neuropathy (DAN), and distal symmetrical polyneuropathy (DSPN) in type 1 and type 2 diabetes. Research design and methods: Cross-sectional study in a tertiary outpatient clinic. CWSS was calculated based on questionnaires: gastroparesis composite symptom index (GCSI) and gastrointestinal symptom rating score (GSRS). DAN and DSPN were addressed using the composite autonomic symptom score 31 (COMPASS-31) questionnaire, cardiac autonomic reflex tests (CARTs), electrochemical skin conductance (ESC), vibration perception threshold (VPT), Michigan Neuropathy Screening Instrument (MNSI), pain- and thermal sensation. Analyses were adjusted for age, sex, diabetes duration, smoking, LDL-cholesterol, HbA1C and systolic blood pressure. Type 1 and type 2 diabetes were evaluated separately. Results: We included 566 with type 1 diabetes and 377 with type 2 diabetes. Mean ± SD age was 58 ± 15 years and 565 (59.9 %) were women. A high CWSS was present in 143 (25 %) with type 1 and 142 (38 %) with type 2 diabetes. The odds of DAN by COMPASS-31 (p < 0.001) were higher in the high score group. For type 1 diabetes, odds of cardiac autonomic neuropathy were higher in the high CWSS group. The odds of DSPN by VPT and MNSI in type 1 diabetes, and by ESC, VPT and pain sensation in type 2 diabetes were higher in the high CWSS group. Conclusions: A high symptom score was associated with neuropathy by COMPASS-31 and vibration perception. Gastrointestinal symptom burden associated inconsistently with other neuropathy tests between diabetes types.
Original language | English |
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Article number | 108745 |
Journal | Journal of Diabetes and its Complications |
Volume | 38 |
Issue number | 5 |
Number of pages | 7 |
ISSN | 1056-8727 |
DOIs | |
Publication status | Published - 2024 |
Bibliographical note
Publisher Copyright:
© 2024
- Cardiovascular autonomic neuropathy, COMPASS-31, Complications, Diabetic neuropathies, Diabetic neuropathy, Distal peripheral neuropathy, Enteric nervous system, Enteropathy distal symmetric polyneuropathy, Gastrointestinal motility, Gastrointestinal symptoms, Gastroparesis, GCSI, GSRS, Type 1 diabetes, Type 2 diabetes
Research areas
ID: 389506320