The Impact of Diabetic Polyneuropathy and Autonomic Neuropathy on the Risk of Ischemic Stroke

Abstract Aim: Type 2 diabetes mellitus (T2DM) can significantly affect stroke outcomes. There is a lack of studies examining the association between diabetic polyneuropathy (DPN), diabetic autonomic neuropathy (DAN), and stroke. This study aimed to investigate the relationship between ischemic stroke by comparing patients with and without DPN. Materials and Methods: Patients diagnosed with DPN who presented to the neurology clinic of Afyonkarahisar Health Sciences University Hospital between January 2022 and January 2023 were included Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Turkey, between January 2022 and January 2023 were included. Demographic information, electromyography results, and findings of DAN were recorded. The presence of DAN symptoms was assessed with the Survey of Autonomic Symptoms. The association of ischemic cerebrovascular (CV) disease was investigated in both groups of patients with and without DPN. Additionally, the relationship between DAN findings and ischemic CV disease was explored in patients with polyneuropathy. Results: A total of 400 patients, comprising 200 with T2DM and DPN and 200 with T2DM without DPN, were included in the study. Ischemic stroke was observed in 23 (11.5%) patients in the group with DPN and 15 (7.5%) patients in the group without polyneuropathy. Although the rate of ischemic stroke was higher in the group with polyneuropathy, no statistically significant difference was found between the groups ( P = 0.232). The presence of DAN was higher in the group with both DPN and ischemic stroke, and this difference was statistically significant ( P < 0.001). Conclusion: The study illustrated that DAN is a significant risk factor for T2DM and CV ischemic stroke. Although a higher rate of ischemic stroke was observed in DPN, the presence of polyneuropathy did not show an additional enhancing effect on the risk of stroke. The rate of CV ischemic stroke in patients with DPN was found to be 11.5%.