Type 2 diabetes in diabetic mellitus neuropathy and osteoporosis relationship

INTRODUCTION: DM is known to be among the causes of secondary osteoporosis. Diabetic polyneuropathy (DPN) is the most common significant microvascular complication of diabetes. In diabetes mellitus, deterioration of bone feeding and reduction of sensory stimuli which is a result of neuropathy are thought to prepare the ground for osteoporosis development. In this study, our goal is to determine the rate of KMY, glycemic control ratio and treatment modality, age and gender of patients with diabetic neuropathy who applied to our polyclinic; to be able to detect their neuropathic relationship, the investigation of the role of DM and diabetic polyneuropathy in the development of osteoporosis, to investigate the presence of osteoporosis during the course of diabetic polyneuropathy to create local demographic data and to determine and collocate the training, follow-up and treatment priorities of patients using the data. MATERIAL- METHODOLOGY: The study was designed as a single-centered cross-sectional study. 145 patients whose DEXA measurement already was fulfilled so as to determine the status of osteoporosis among the ones was diagnosed with type 2 diabetes or newly diagnosed with neuropathy with DN4 (Douleur Neuropathique 4 questions) neuropathy pain questioning criteria in patients who admitted to Bozok University, Faculty of Medicine, Department of Internal Medicine between March 1,2017 and June 30,2017 were included in the study. Those with additional illness that may affect KMY or drug users were not included in the study. Sociodemographic data of patients were recorded. Diabetic-related data from blood samples taken were recorded. KMY values were determined in the measurements made for DEXA. The relationship between diabetes, neuropathy and osteoporosis was examined by statistical analysis. FINDINGS: According to statistical data, the mean DN4 score of the patients who were studied according to the DN4 (Douleur Neuropathique 4 questions) questionnaire used for the neuropathy test was determined as 5,71. It was observed that feminine patients had higher neuropathy DN4 score than males (p:0,032). Neuropathy severity, age, body mass index and duration of diabetes were not correlated (respectively p:0,77; 0,83; 0,18). It was found that there was a positive correlation between HbA1c levels and DN4 score of the patients (p:0,034), DN4 score of women in hijab was higher(p <0,001), DN4 score increased as the duration of menopause increased (p:0,01) and the smoker had higher DN4 score (p 36 <0,001). It was determined that the serum vitamin D level decreased, the severity of diabetic neuropathy increased (p <0,001). The mean lumber part T score of the diabetic neuropathic patients detected by KMY DEXA technique was stated as -2,40, femur total score was stated as -1,35 and femur KMY was stated as 0,98 ( gr/cm2). While osteoporosis in 72 patients and osteopenia in 62 patients were found, 11 patients had normal KMY. There was a significant relationship between the severity of diabetic neuropathy and the degree of loss of bone mineral density. It was determined that as the severity of neuropathy increased, the bone mineral density decreased for both the lumbar part and the femur part. It was found that as the duration of menopause was prolonged, there was a decrease in bone mineral density in both femur and lumbar part. RESULTS: As a result of our study, it is found that diabetic polyneuropathy accelerates osteoporosis in the lumbar and femur part and the neuropathy severity and the loss of bone mineral density are higher in the individuals in hijab. We are in the opinion that neuropathy has also been shown to impair diabetes regulation and accelerate osteoporosis by restricting bone circulation and exercise. It is needed that neuropathy and osteoporosis are considered as significant health problems following-up diabetic patients and take necessary preventive measures and it should not be ignored that osteoporosis is also a complication of diabetes.