Relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability

ABSTRACT Aims/Introduction We evaluated the 24‐h ambulatory blood pressure monitoring data of patients to investigate the relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability. Materials and Methods This study included 154 patients with dia...

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Main Authors: Dai Yamagami, Takahisa Deguchi, Aiko Arimura, Yoshihiko Nishio
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Journal of Diabetes Investigation
Subjects:
Online Access:https://doi.org/10.1111/jdi.14282
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author Dai Yamagami
Takahisa Deguchi
Aiko Arimura
Yoshihiko Nishio
author_facet Dai Yamagami
Takahisa Deguchi
Aiko Arimura
Yoshihiko Nishio
author_sort Dai Yamagami
collection DOAJ
description ABSTRACT Aims/Introduction We evaluated the 24‐h ambulatory blood pressure monitoring data of patients to investigate the relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability. Materials and Methods This study included 154 patients with diabetes who were hospitalized for hyperglycemic control. Routine biochemical and hematological tests, ambulatory blood pressure monitoring, screening for diabetic complications, nerve conduction studies, and Holter electrocardiography were carried out on all patients. They were classified according to the Baba classification and the clinical staging for diabetic polyneuropathy, and their ambulatory blood pressure monitoring data were compared. Results The patients were classified into stages 0 (n = 64), I (n = 42), II (n = 24), III (n = 11) and IV (n = 13) according to the Baba classification. As the severity of diabetic polyneuropathy progressed, the degree of nocturnal blood pressure reduction decreased and the percentage of patients with riser‐type impaired circadian blood pressure variability increased. Similar results were observed in patients classified according to the clinical staging for diabetic polyneuropathy. In the multivariate logistic regression analysis, the severity of diabetic neuropathy and urinary albumin excretion were independently associated with the percentage of patients with riser‐type. However, the adjusted odds ratio was the highest for Baba class I and decreased with increasing severity. Conclusions Patients with progressive diabetic polyneuropathy and renal impairment often show impaired circadian blood pressure variability. The progression of electrophysiological and clinical neuropathy is associated with riser‐type circadian blood pressure variability independent of urinary albumin excretion, insulin therapy, renin–angiotensin–aldosterone system inhibitor medication and body mass index.
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spelling doaj-art-d27c66958aec4b3383ced04398a83e4c2025-08-20T03:05:07ZengWileyJournal of Diabetes Investigation2040-11162040-11242025-03-0116346347410.1111/jdi.14282Relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variabilityDai Yamagami0Takahisa Deguchi1Aiko Arimura2Yoshihiko Nishio3Department of Diabetes and Endocrine Medicine Kagoshima University Graduate School of Medicine and Dental Sciences Kagoshima JapanDepartment of Diabetes and Endocrine Medicine Kagoshima University Graduate School of Medicine and Dental Sciences Kagoshima JapanDepartment of Diabetes and Endocrine Medicine Kagoshima University Graduate School of Medicine and Dental Sciences Kagoshima JapanDepartment of Diabetes and Endocrine Medicine Kagoshima University Graduate School of Medicine and Dental Sciences Kagoshima JapanABSTRACT Aims/Introduction We evaluated the 24‐h ambulatory blood pressure monitoring data of patients to investigate the relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability. Materials and Methods This study included 154 patients with diabetes who were hospitalized for hyperglycemic control. Routine biochemical and hematological tests, ambulatory blood pressure monitoring, screening for diabetic complications, nerve conduction studies, and Holter electrocardiography were carried out on all patients. They were classified according to the Baba classification and the clinical staging for diabetic polyneuropathy, and their ambulatory blood pressure monitoring data were compared. Results The patients were classified into stages 0 (n = 64), I (n = 42), II (n = 24), III (n = 11) and IV (n = 13) according to the Baba classification. As the severity of diabetic polyneuropathy progressed, the degree of nocturnal blood pressure reduction decreased and the percentage of patients with riser‐type impaired circadian blood pressure variability increased. Similar results were observed in patients classified according to the clinical staging for diabetic polyneuropathy. In the multivariate logistic regression analysis, the severity of diabetic neuropathy and urinary albumin excretion were independently associated with the percentage of patients with riser‐type. However, the adjusted odds ratio was the highest for Baba class I and decreased with increasing severity. Conclusions Patients with progressive diabetic polyneuropathy and renal impairment often show impaired circadian blood pressure variability. The progression of electrophysiological and clinical neuropathy is associated with riser‐type circadian blood pressure variability independent of urinary albumin excretion, insulin therapy, renin–angiotensin–aldosterone system inhibitor medication and body mass index.https://doi.org/10.1111/jdi.14282AlbuminuriaBlood pressureDiabetic polyneuropathy
spellingShingle Dai Yamagami
Takahisa Deguchi
Aiko Arimura
Yoshihiko Nishio
Relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability
Journal of Diabetes Investigation
Albuminuria
Blood pressure
Diabetic polyneuropathy
title Relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability
title_full Relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability
title_fullStr Relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability
title_full_unstemmed Relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability
title_short Relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability
title_sort relationship between the progression of diabetic polyneuropathy and impaired circadian blood pressure variability
topic Albuminuria
Blood pressure
Diabetic polyneuropathy
url https://doi.org/10.1111/jdi.14282
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