Table 2. Prevalence of subjective symptoms and diminished Achilles tendon reflex in 593 diabetic patients by defined diabetic symmetric polyneuropathy and cardiovascular autonomic neuropathy.
| Probable DSPN | Confirmed DSPN | Possible CAN | Advanced CAN | |||||
|---|---|---|---|---|---|---|---|---|
| No n = 367 (%) | Yes n = 214 (%) | No n = 377 (%) | Yes n = 162 (%) | No n = 270 (%) | Yes n = 297 (%) | No n = 499 (%) | Yes n = 75 (%) | |
| Subjective symptoms | ||||||||
| Numbness in toe and sole | ||||||||
| No symptom | 289 (78.8) | 108 (50.5) | 287 (76.1) | 76 (46.9) | 209 (77.4) | 174 (58.6) | 351 (70.4) | 36 (48.0) |
| Unilateral | 13 (3.5) | 11 (5.1) | 20 (5.3) | 4 (2.5) | 16 (5.9) | 10 (3.4) | 26 (5.2) | 0 (0)* |
| Bilateral | 65 (17.7) | 95 (44.4)*** | 70 (18.6) | 82 (50.6)*** | 45 (16.7) | 113 (38.0)*** | 122 (24.4) | 39 (52.0)*** |
| Paresthesia in toe and sole | ||||||||
| No symptom | 324 (88.2) | 146 (68.2) | 331 (87.8) | 105 (64.8) | 239 (88.5) | 221 (74.4) | 415 (83.2) | 50 (66.7) |
| Unilateral | 9 (2.5) | 4 (1.9) | 11 (2.9) | 1 (0.6) | 7 (2.6) | 6 (2.0) | 12 (2.4) | 1 (1.3) |
| Bilateral | 34 (9.3) | 64 (29.9)*** | 35 (9.3) | 56 (34.6)*** | 24 (8.9) | 70 (23.6)*** | 72 (14.4) | 24 (32.0)*** |
| Numbness in hand | ||||||||
| No symptom | 317 (86.3) | 167 (78.0) | 319 (84.6) | 130 (80.3) | 227 (84.1) | 243 (81.8) | 420 (84.2) | 57 (76.0) |
| Unilateral | 19 (5.2) | 10 (4.7) | 20 (5.3) | 7 (4.3) | 13 (4.8) | 15 (5.1) | 25 (5.0) | 2 (2.7) |
| Bilateral | 31 (8.5) | 37 (17.3)** | 38 (10.1) | 25 (15.4) | 30 (11.1) | 39 (13.1) | 54 (10.8) | 16 (21.3)** |
| Pain in foot | ||||||||
| No symptom | 332 (90.5) | 162 (75.7) | 337 (89.3) | 117 (72.2) | 242 (89.6) | 241(81.1) | 430 (86.2) | 59 (78.7) |
| Unilateral | 7 (1.9) | 5 (2.3) | 7 (1.9) | 5 (3.1) | 4 (1.5) | 8 (2.7) | 11 (2.2) | 1 (1.3) |
| Bilateral | 28 (7.6) | 47 (22.0)*** | 33 (8.8) | 40 (24.7)*** | 24 (8.9) | 48 (16.2)** | 58 (11.6) | 15 (20.0)* |
| Pain in hand | ||||||||
| No symptom | 357 (97.3) | 202 (94.4) | 365 (96.8) | 153 (94.5) | 257 (95.2) | 288 (97.0) | 480 (96.2) | 72 (96.0) |
| Unilateral | 6 (1.6) | 1 (0.5) | 5 (1.3) | 1 (0.6) | 6 (2.2) | 1 (0.3) | 7 (1.4) | 0 (0) |
| Bilateral | 4 (1.1) | 11 (5.1)** | 7 (1.9) | 8 (4.9)* | 7 (2.6) | 8 (2.7) | 12 (2.4) | 3 (4.0) |
| Coldness in legs | ||||||||
| No symptom | 89/125 (71.2) | 28/46 (60.9) | 67/93 (72.0) | 30/45 (66.7) | 48/67 (71.6) | 58/93 (62.4) | 97/142 (68.3) | 14/22 (63.6) |
| Symptomatic | 36/125 (28.8) | 18/46 (39.1) | 26/93 (28.0) | 15/45 (33.3) | 19/67 (28.4) | 35/93 (37.6) | 45/142 (31.7) | 8/22 (36.4) |
| Painful leg cramp | ||||||||
| No symptom | 261/348 (75.0) | 132/194 (68.0) | 251/358 (70.1) | 113/146 (77.4) | 191/257 (74.3) | 198/275 (72.0) | 340/469 (72.5) | 50/68 (73.5) |
| Symptomatic | 87/348 (25.0) | 62/194 (32.0) | 107/358 (29.9) | 33/146 (22.6) | 66/257 (25.7) | 77/275 (28.0) | 129/469 (27.5) | 18/68 (26.5) |
| Dizziness on standing | ||||||||
| No symptom | 293/365 (80.3) | 144/210 (68.6) | 301/375 (80.3) | 101/158 (63.9) | 222 (82.2) | 205/291 (70.4) | 388/495 (78.4) | 47/74 (63.5) |
| Symptomatic | 72/365 (19.7) | 66/210 (31.4)** | 74/375 (19.7) | 57/158 (36.1)*** | 48 (17.8) | 86/291 (29.5)** | 107/495 (21.6) | 27/74 (34.5)** |
| Sweating restricted to face/trunk | ||||||||
| No symptom | 301/366 (82.2) | 152/208 (73.1) | 311/376 (82.7) | 107/156 (68.6) | 227 (84.1) | 218/291 (74.9) | 403/493 (81.7) | 47/74 (63.5) |
| Symptomatic | 65/366 (17.8) | 56/208 (26.9)** | 65/376 (17.3) | 49/156 (31.4)*** | 43 (15.9) | 73/291 (25.1)** | 90/493 (18.3) | 27/74 (36.5)*** |
| Frequent constipation/diarrhea | ||||||||
| No symptom | 335/366 (91.5) | 172/208 (82.7) | 339/376 (90.2) | 128/156 (82.1) | 247 (91.5) | 247/291 (84.9) | 444/493 (90.1) | 58/74 (78.4) |
| Symptomatic | 31/366 (8.5) | 36/208 (17.3)** | 37/376 (9.8) | 28/156 (17.9)** | 23 (8.5) | 44/291 (15.1)* | 49/493(9.9) | 16/74 (21.6)** |
| Objective nerve function test | ||||||||
| Achilles tendon reflex | ||||||||
| Normal | 175/351(49.9) | 0 (30.4) | 158/358 (44.1) | 11 (6.8) | 120/258 (46.5) | 48/283 (17.0) | 162/475 (34.1) | 8/71(11.3) |
| Unilaterally decreased | 7/351 (2.0) | 0 (0)* | 6/358 (1.7) | 1 (0.6) | 2/258(0.8) | 4/283 (1.4) | 5/475 (1.1) | 1/71(1.4) |
| Bilaterally decreased | 169/351 (48.1) | 214 (100.0)*** | 194/358(54.2) | 150 (92.6)*** | 136/258 (52.7) | 231/283 (81.6)*** | 308/475 (64.8) | 62/71 (87.3)*** |
Relationships between symptoms or Achilles tendon reflex and defined types of diabetic symmetric polyneuropathy (DSPN) and cardiovascular autonomic neuropathy (CAN) according to the statement of American Diabetes Association were evaluated. Unilateral and bilateral symptoms were separately analyzed. *P < 0.05, **P < 0.01, ***P < 0.001 analyzed by chi‐squared‐test for 2 × 2 contingency table.