Diabetic neuropathy in elderly Type 2 diabetic patients: effects of insulin treatment

Objectives - To study the occurrence of diabetic neuropathy and the effect of insulin treatment in elderly Type 2 diabetic patients. Material and meth ods - In 38 patients and 20 controls symptoms and neurophysiological examin ations including electroneurography, vibration perception and temperature d iscrimination thresholds were investigated. Patients were randomized to ins ulin (n = 18) or sulfonylurea (n = 16) treatment and were re-investigated a fter 1 year. Results - Neuropathy was present in 21/38 patients (56%). It w as asymptomatic in 17/38 (45%) and symptomatic in 4/38 (11%). The occurrenc e of neuropathy was less common in healthy controls, 3/20 (15%) (P<0.01). T emperature discrimination thresholds was the test that most often revealed pathology. The metabolic control after 1 year was significantly improved in the insulin treated group and unchanged in the sulfonylurea treated group. There were no changes as regards occurrence of neuropathy between or withi n the two treatment groups after 1 year. Conclusion - Diabetic neuropathy i s common among elderly Type 2 diabetic patients. It is mostly asymptomatic. Improvement was not seen after 1 year of insulin treatment.