The SA Journal Diabetes & Vascular Disease Vol 12 No 1 (July 2015)

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42 VOLUME 12 NUMBER 1 • JULY 2015
NEWS SA JOURNAL OF DIABETES & VASCULAR DISEASE
Aprospective study found that diabetic
haemodialysis patients’ subclinical
hyperthyroidism and euthyroid sick syn-
drome might increase the risk of sudden
cardiac-relateddeaths.DrChristianeDrechsler,
of University Hospital Würzburg in Würzburg,
Germany, and colleagues conducted a study
that included 1 000 patients undergoing
haemodialysis for diabetes. Of those
patients, 78.1% had euthyroidism, 13.7%
had subclinical hyperthyroidism, 1.6% had
subclinical hypothyroidism and 5.4% had
euthyroid sick syndrome.
Patients with euthyroidism were
Cardiac death risk in diabetic haemodialysis patients increased due to
thyroid problems
compared with those who had subclinical
hyperthyroidism and euthyroid sick
syndrome, with regard to which group
showed an increased short-term (within
a 12-month period) risk of sudden cardiac
death. It showed that patients who had
euthyroidism had a 2.0-times increased
short-term risk of sudden cardiac death, and
those who had subclinical hyperthyroidism
and euthyroid sick syndrome had a 2.7-fold
increase.
The results showed that euthyroid sick
syndrome was associated with a three-fold
increased risk of short-term mortality, but in
the long term (two to four years) it showed
no increased risk. The study revealed
that subclinical hypothyroidism was not
associated with cardiovascular events or
all-cause mortality, which revealed thyroid
disorders had no influence on the risks of
myocardial infarction and stroke.
This study led researchers to conclude,
‘Regularly assessing a patient’s thyroid status
may help estimate the cardiac risk of dialysis
patients.’
Source:
problems-up-cardiac-death-risk-in-diabetic-hd-patients/
article/348571/
Painful diabetic neuropathy (PDPN) has
been associated with higher nocturnal
blood pressure in patients, according
to a study by D’Amato et al. published
in the 10 July 2014 issue of Diabetes
Care. PDPN can cause obstructive sleep
apnoea (OSA) and affect quality of life. As
this condition is often underdiagnosed,
researchers conducted a study focusing on
the increasing cardiovascular risk associated
with neuropathic pain.
The study included a total of 113 diabetes
patients with PDPN (n = 34), patients with
painless diabetic polyneuropathy (n = 33),
and those without diabetic polyneuropathy
(n = 46). Neuropathic pain, risk of obstructive
sleep apnoea, autonomic function and blood
pressure were all assessed using the Douleru
Neuropathique en 4 Questions (DN4).
Nocturnal systolic blood pressure was sig-
nificantly higher in patients with PDPN (130.4
± 15.6 mmHg) than in those without diabetic
polyneuropathy (119.9 ± 10.6 mmHg; p <
0.0001) and in those with painless polyneu-
ropathy (124.2 ± 12.3 mmHg; p < 0.05). The
PDPN group also experienced less change in
systolic and diastolic blood pressure overnight
when compared to those without diabetic
polyneuropathy (p < 0.05). The ‘non-dipping’
decrease in blood pressure overnight was
Painful neuropathy and increasing blood pressure
seen in eight patients, which was highly cor-
related to PDPN status (p = 0.007).
The researchers concluded that PDPN
is associated with higher nocturnal blood
pressure that is independent of pain-
related sleep problems and other diabetes-
related co-morbidities. The theory is that
neuropathic pain acts as a stressor, which
induces sympathetic response during the
night and inhibits the blood pressure from
falling. This highlights the importance of
managing the patient’s cardiovascular risk
more closely while attempting to treat the
neuropathic pain at the same time.
Source:
diabetes-news/16624-painful-neuropathy-and-
increasing-blood-pressure
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