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The
th Annual Meeting of March 21-22, 2015 The Endocrine Society and The Diabetes Association of the R.O.C. (Taiwan)
OD-01
EXERCISE AND THE RISK OF PAINFUL NEUROPATHY IN PATIENTS WITH TYPE 2 DIABETES SHEN-SHU CHIANG, CHIA-LIN LEE, SHI-YI LIN, SHEU-JANE LIU, JUN-SING WANG, YEN-MIN SONG, I-TE LEE, CHIA-PO FU, WAYNE HUEY-HERNG SHEU Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan, R.O.C.
Introduction: Diabetic neuropathy is one of the most common complications in the patients with type 2 diabetes mellitus (T2DM). Currently, there are no specific therapy that could improve the neuropathy except glycemic control. In recent years, few studies revealed that moderate intensity aerobic exercise could play a valuable role to slow down the progression of diabetic peripheral neuropathy. The aim of our study was to analysis the relationship between diabetic painful neuropathy (DPN) and exercise. Method: This cross-sectional study totally enrolled 2359 outpatients with type 2 diabetes who had completed the Douleur Neuropathique en 4 Questions (DN4) questionnaire from January 2013 to October 2013. The Patients’ characteristics, including age, sex, DM duration, anti-diabetic medication, anti-hypertensive and lipid-lowering medication, medication for diabetic neuropathy, HbA1c, systolic blood pressure, body weight and height, serum creatinine level, urine albumin to creatinine ratio, and daily exercise duration were recorded. A total score of DN4 questionnaire equal or greater than 4 was defined as having DPN. Linear regression was used to evaluate the correlation between duration of exercise and DN4 score. General linear model (GLM) was used to assess the effect of exercise and risk of painful neuropathy. Results: There were 179 patients with DPN, in whom 83 were men (46.4%), mean age 69.6±12.5 years old, BMI 25.5±4.1 kg/m2, diabetes duration 13.3±9.3 years, mean DN4 score 4.49±0.75, HbA1c 7.8±1.7%, insulin users 22.9%. It was found that longer daily exercise duration was associated with a lower mean DN4 score. The mean DN4 score was 0.74, 0.62, and 0.45 in the subjects with no exercise, daily exerciseduration ≦ 30 minutes, and daily exercise duration longer than 30 minutes, respectively (P for trend <0.001.) After adjusting the sex, age, diabetes duration, neuropathy medication usage, insulin user, oral anti-diabetics drugs, systolic blood pressure, body mass index, glycated hemoglobin, low-density lipoprotein, and estimated GFR, the risk of painful neuropathy was 3.38 times in the no exercise group(95% CI 1.54-9.79)in comparison with the group with daily exercise duration more than 30 minutes. Conclusion: The risk of painful neuropathy is markedly increased in the diabetic patients without exercise habits.
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