J Korean Acad Rehabil Med.  2006 Feb;30(1):25-32.

The Effect of Peripheral Vascular Disease on Diabetic Neuropathy

• Park GY
• Park JH
• Lee SE
• Kang HK
• Chung ME
• Seong NS

Abstract

OBJECTIVE
To evaluate the effect of peripheral vascular disease (PVD) on diabetic neuropathy with the use of Doppler ultrasound and electrodiagnostic study. METHOD: One hundred fifty one patients with diabetes mellitus underwent nerve conduction studies. PVD was diagnosed when ankle-brachial index (ABI) was 0.9 and less and also toe-brachial index (TBI) was 0.7 and less. Electrophysiologically normal group was subdivided into non- PVD group (A1) and PVD group (A2). Diabetic neuropathy group was subdivided into non-PVD group (B1) and PVD group (B2). The frequency of diabetic neuropathy and the difference of amplitude, conduction velocity, and F wave latency within A groups and B groups were investigated.
RESULTS
Diabetic neuropathy was significantly correlated with PVD (p<0.05). There was no definite difference of electrophysiologic parameters between A1 and A2 groups. B1 group showed significantly reduced amplitude of sensory nerve action potential (SNAP) in sural nerve compared with B2 group (p<0.05). In all patients, the amplitude of SNAP in sural nerve was related with duration of diabetes and TBI by multiple linear regression analysis.
CONCLUSION
This study supports the influence of PVD on diabetic neuropathy and suggests vascular abnormality in patients with diabetic neuropathy may result in predominantly axonal injury rather than demyelinating injury.

Keyword

Diabetic neuropathy; Ankle-brachial index; Toe-brachial index; Nerve conduction study; Peripheral vascular disease

MeSH Terms

Action Potentials
Ankle Brachial Index
Axons
Diabetes Mellitus
Diabetic Neuropathies*
Humans
Linear Models
Neural Conduction
Peripheral Vascular Diseases*
Sural Nerve
Ultrasonography