Prevelance of ischemic cerebrovascular disease in diabetic polyneuropathy

It is known that diabetes is an independent risk factor for ischemic stroke. In this study, we aimed to determine the prevalence of ischemic cerebrovascular disease in patients diagnosed with diabetic polyneuropathy with type 2 DM for at least 2 years and in patients who were not diagnosed with polyneuropathy. In addition, the relationship between autonomic findings and ischemic cerebrovascular disease in patients with polyneuropathy was investigated. We organized this study as a controlled cross-sectional study. Patients who applied to the neurology outpatient clinic of Afyonkarahisar Health Sciences University Faculty of Medicine Hospital between January 1, 2022, and January 1, 2023, were diagnosed with diabetic polyneuropathy with an electrophysiological diagnosis were included. Demographic information, hemoglobin A1c level, EMG, and autonomic neuropathy findings of the patients were recorded in the form. We compared the prevalence of ischemic cerebrovascular disease in both groups of patients who were previously diagnosed with diabetes and did not have polyneuropathy at presentation. 400 patients, 200 patients with type 2 DM diagnosis and diabetic polyneuropathy and 200 patients with type 2 DM diagnosis without diabetic polyneuropathy were included in the study. In the polyneuropathy group, the mean age was 62.3±9.9 years, the hemoglobin a 1c level was 8.5±2.2, the mean diabetes diagnosis time was 13.4±6.7 years , mean duration of ischemic cerebrovascular disease was 1.49±4.7 years, mean polyneuropathy development time was 3.5±2.4 years. In the group without polyneuropathy, the mean age was 62.8±8.9 years, hemoglobin a 1c level was 7.6±1.9, mean diabetes diagnosis time was 10.3±5.8 years, mean duration of ischemic cerebrovascular disease was found to be 1.49±4.7 years. In the diabetic polyneuropathy group, 104 (52.0%) patients were male and 96 (48.0%) patients were female. In the group without polyneuropathy, 77 (38.5%) patients were male and 123 (61.5%) were female. Of the total number of patients, 181(45.2%) patients were male and 219 (54.8%) were female. Ischemic stroke was detected in 23 (11.5%) patients in the diabetic polyneuropathy group. In the group without polyneuropathy, ischemic stroke was detected in 15 patients (7.5%). We found autonomic involvement in 22 patients with ischemic stroke in the group with diabetic polyneuropathy and in 2 patients with ischemic stroke in the group without polyneuropathy. We found autonomic involvement was higher in the group with diabetic polyneuropathy and ischemic stroke, and it was statistically significant. In conclusion, we did not see diabetic polyneuropathy as an increased risk factor for ischemic stroke in this study. However, the association between diabetic polyneuropathy and autonomic neuropathy was found to be an increased risk factor for ischemic cerebrovascular disease. It shows the relationship between the autonomic nervous system with ischemic cerebrovascular disease.