Diabetic polyneuropathy, deep white matter lesions, and carotid atherosclerosis: is there any association?

The morphologic and functional damages of diabetes mellitus (DM) on microcirculation can play a role in the pathogenesis of both polyneuropathy and cerebral white matter lesions. The aim of this study is to investigate the relation between polyneuropathy and cerebral deep white matter lesions (DWMLs) and carotid atherosclerosis in patients with type 2 DM. Sixty-six patients with type 2 DM without any disorder that may cause polyneuropathy, and vascular risk factors except for DM and hyperlipidemia were included in the study. DWMLs and carotid atherosclerosis were investigated in patients with and without polyneuropathy. Forty patients (60.6%) had diabetic sensorimotor polyneuropathy. DWMLs were more frequent in patients with polyneuropathy compared to patients without polyneuropathy (p = 0.003). Logistic regression analysis confirmed association between polyneuropathy and DWMLs after adjusted for age (p = 0.013), duration of DM (p = 0.007), and both age and duration of DM (p = 0.016). No statistically significant difference was found between patients with and without polyneuropathy for carotid atherosclerosis. Among patients with polyneuropathy, those having DWMLs had higher mean age (p = 0.003) and longer symptom duration (p = 0.020) compared to patients without DWMLs. No association was found between DWMLs and carotid atherosclerosis. Polyneuropathy and cerebral DWMLs in type 2 DM patients may share common pathogenesis; presence and duration of polyneuropathy symptoms may predict ischemic white matter damage independent of carotid atherosclerosis.