Vascular insufficiency quantitatively aggravates diabetic neuropathy
Z. Ram, M. Sadeh, R. Walden and R. Adar
Department of Neurosurgery, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
The effect of lower-limb ischemia on the severity of neuropathy was
examined in 48 diabetic patients with peripheral vascular disease. The
severity of the vascular disease, as determined by medical history,
physical findings, and laboratory data, was scored for each leg. Neuropathy
was rated clinically and based on the results of nerve conduction studies
of the common peroneal, posterior tibial, and sural nerves. A significant
correlation was found between the vascular scores and neurologic variables
of the two legs, most strikingly so in electrophysiologic data, with
coefficients of .6 to .7. Nondiabetic control patients showed no evidence
of neuropathy, regardless of the severity of ischemia, whereas diabetic
controls without limb ischemia showed symmetrical neuropathy. These
findings support the hypoxic theory in the pathogenesis of diabetic
neuropathy.
