Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine
Abstract 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 severi...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-023-01036-7 |
| _version_ | 1827956695680155648 |
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| author | Ana Raquel Souza de Azevedo Vieira Lara Benigno Porto-Dantas Flaviene Alves do Prado Romani Patrícia Souza Carvalho Rodica Pop-Busui Hermelinda Cordeiro Pedrosa |
| author_facet | Ana Raquel Souza de Azevedo Vieira Lara Benigno Porto-Dantas Flaviene Alves do Prado Romani Patrícia Souza Carvalho Rodica Pop-Busui Hermelinda Cordeiro Pedrosa |
| author_sort | Ana Raquel Souza de Azevedo Vieira |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-09T15:07:47Z |
| format | Article |
| id | doaj.art-bb185058e8444bbcaa7f143b384932c4 |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-04-09T15:07:47Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-bb185058e8444bbcaa7f143b384932c42023-04-30T11:22:49ZengBMCDiabetology & Metabolic Syndrome1758-59962023-04-011511910.1186/s13098-023-01036-7Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routineAna Raquel Souza de Azevedo Vieira0Lara Benigno Porto-Dantas1Flaviene Alves do Prado Romani2Patrícia Souza Carvalho3Rodica Pop-Busui4Hermelinda Cordeiro Pedrosa5Unit of Endocrinology of the Regional Hospital of Taguatinga and Research Center of the Foundation for Education and Research in Health Sciences, Secretariat of Health of the Federal DistrictUnit of Endocrinology of the Regional Hospital of Taguatinga and Research Center of the Foundation for Education and Research in Health Sciences, Secretariat of Health of the Federal DistrictUnit of Endocrinology of the Regional Hospital of Taguatinga and Research Center of the Foundation for Education and Research in Health Sciences, Secretariat of Health of the Federal DistrictUnit of Endocrinology of the Regional Hospital of Taguatinga and Research Center of the Foundation for Education and Research in Health Sciences, Secretariat of Health of the Federal DistrictDivision of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of MichiganDivision of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of MichiganAbstract 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.https://doi.org/10.1186/s13098-023-01036-7Diabetic autonomic symptomsAutonomic neuropathySudomotor dysfunctionScreening tests |
| spellingShingle | Ana Raquel Souza de Azevedo Vieira Lara Benigno Porto-Dantas Flaviene Alves do Prado Romani Patrícia Souza Carvalho Rodica Pop-Busui Hermelinda Cordeiro Pedrosa Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine Diabetology & Metabolic Syndrome Diabetic autonomic symptoms Autonomic neuropathy Sudomotor dysfunction Screening tests |
| 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 | Diabetic autonomic symptoms Autonomic neuropathy Sudomotor dysfunction Screening tests |
| url | https://doi.org/10.1186/s13098-023-01036-7 |
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