Cabezas-Cerrato J
Department of Endocrinology and Nutrition, C.H.U.S., Santiago de Compostela, Spain.
Diabetologia. 1998 Nov;41(11):1263-9. doi: 10.1007/s001250051063.
A multiregional cross-sectional study of clinical diabetic polyneuropathy (DPN) was carried out among Spanish diabetes patients using a standard system for scoring symptoms and signs of polyneuropathy. The main patient sample comprised 2644 patients (54.7% women) aged 15-74 years (mean 57.2 +/- 0.3 years), 86.9% of whom had Type II (non-insulin-dependent) diabetes mellitus and 29.4% were attending hospital clinics. Mean duration of diabetes since diagnosis was 10.2 +/- 0.2 years. The prevalence of DPN was 22.7% (95% confidence interval 21.2-24.3%) in the whole sample, 12.9% (9.4-16.5%) among patients with Type I (insulin-dependent) diabetes mellitus and 24.1% (22.4-25.9%) among patients with Type II diabetes; there was no significant difference in prevalence between men and women. Prevalence increased with age (from < 5% in the 15- to 19-year-old age group to 29.5% in the 70- to 74-year-old group) and with duration of diabetes since diagnosis (from 14.2% among those with duration < 5 years to 44.2% among those with duration > 30 years). In a supplementary sample of 161 diabetic patients aged 75 to 79 years (excluded from the main sample to prevent confusion between diabetes-induced and ageing-induced neuropathies), prevalence was 37.8%. Ninety-three patients (3.3%) had or had had foot ulcers and 21 of these 93 (0.7%) had undergone amputation; 90.8% of ulcerated patients had Type II diabetes, and 54% had DPN (in most cases with loss of perception of vibration), as against a prevalence of DPN of 19.9% among patients without ulcers. We conclude that nearly a quarter of Spanish diabetic patients have DPN; that over 90% of DPN patients have Type II diabetes; that the prevalence of DPN increases with age and with the duration of the disease, and that the risk of foot ulcers among DPN patients is about three times the risk among diabetic patients without DPN. We accordingly emphasize the responsibility of primary care physicians to try to prevent diabetic foot lesions by early diagnosis of DPN.
一项针对西班牙糖尿病患者的临床糖尿病性多发性神经病变（DPN）的多地区横断面研究，采用了一种用于对多发性神经病变的症状和体征进行评分的标准系统。主要患者样本包括2644名年龄在15至74岁（平均57.2±0.3岁）的患者（女性占54.7%），其中86.9%患有II型（非胰岛素依赖型）糖尿病，29.4%在医院门诊就诊。自诊断以来糖尿病的平均病程为10.2±0.2年。整个样本中DPN的患病率为22.7%（95%置信区间21.2 - 24.3%），I型（胰岛素依赖型）糖尿病患者中为12.9%（9.4 - 16.5%），II型糖尿病患者中为24.1%（22.4 - 25.9%）；男女患病率无显著差异。患病率随年龄增长（从15至19岁年龄组的<5%增至70至74岁组的29.5%）以及自诊断以来糖尿病的病程增加（从病程<5年者中的14.2%增至病程>30年者中的44.2%）而升高。在一个由161名7
