Diabetic Neuropathy and Risk of Cardiovascular Disease

Neuropathy is a common complication of diabetes that can appear in the early stages of diabetes or even in the prediabetes stage. The relationship between autonomic neuropathy and cardiovascular disease (CVD) is well established. Resting tachycardia, exercise intolerance, and non-dipping/reverse dipping caused by the relative overactivity of the sympathetic nervous system are the main factors that lead to the increased risk of CVD and cardiovascular mortality. Little is known, however, about the cardiovascular consequences of peripheral neuropathy (PN). Two recent major studies suggested the possibility of a significant association between PN and CVD and mortality; thus, cardiovascular risk management for patients with PN may be necessary. Positive results on MNSI (Michigan Neuropathy Screening Instrument) questionnaires and 10-g monofilament test are convenient methods for early screening and management of PN that may also be useful in evaluating PN-related CVD risk.