Sex Differences in Cardiovascular Risk and Diabetic Polyneuropathy: A Single-Center Retrospective Study in North-Eastern Hungary

<b>Background/Objectives</b>: Diabetic sensorimotor polyneuropathy (DSPN) is a frequent microvascular complication of diabetes mellitus, associated with increased morbidity and reduced quality of life. The existing literature offers a limited understanding of sex-specific cardiovascular risk profiles and their association with DSPN, particularly within Central and Eastern European populations. <b>Methods</b>: A retrospective analysis was conducted using data from 621 individuals with type 1 or type 2 diabetes mellitus who underwent comprehensive neuropathy screening at the University of Debrecen between 2017 and 2021. The diagnosis of DSPN was made in accordance with international criteria, incorporating symptom scores, and electrophysiological measurements. Multivariate logistic regression was applied in order to identify independent predictors. <b>Results</b>: The diagnosis of DSPN was made in 444 individuals (71.5%), of whom 58.2% were female. Despite similar glycemic control (HbA1c: 7.81% in men vs. 7.65% in women, <i>p</i> = 0.297), men had significantly more frequent occurrences of previous myocardial infarction (11.8% vs. 5.0%, <i>p</i> = 0.008), peripheral vascular disease (19.9% vs. 12.7%, <i>p</i> = 0.041) and atherosclerosis (31.7% vs. 22.0%, <i>p</i> = 0.021). Multivariate analysis showed that female gender was independently associated with a lower incidence of DSPN (odds ratio [OR] = 0.592, 95% confidence interval [CI]: 0.369-0.950, <i>p</i> = 0.030), while diabetic retinopathy was a significant predictor (OR = 2.728, 95% CI: 1.300-5.725, <i>p</i> = 0.008). Electrophysiological testing revealed lower nerve conduction amplitudes in females for selected nerves. <b>Conclusions</b>: Our findings highlight sex-specific differences in neuropathy risk and support the implementation of individualized screening strategies in diabetic populations with region-specific risk factors.