NGHIÊN CỨU ĐÁP ỨNG GIAO CẢM DA Ở NGƯỜI BỆNH ĐÁI THÁO ĐƯỜNG TYP 2

Abstract

Sympathetic skin response (SSR) is a test that investigates the sympathetic function of the peripheral nervous system. It is easy to perform and can be repeated multiple times. When there is a stimulus such as pain, stress, or anxiety, the sympathetic system increases the secretion of acetylcholine in the periphery, causing an increase in sweat production and resulting in changes in skin impedance. An electromechanical device records these oscillations, which are represented as an SSR waveform. The latency of the waveform is measured from the onset of the stimulus to the appearance of the response potential (ms), and the amplitude is measured as the distance between the two peaks of the waveform (μV). The absence of a reflex is considered an abnormal result. The research objectives: 1. To investigate SSR in patients with type 2 diabetes at the Hanoi Medical University Hospital. 2. To explore factors related to SSR in patients with type 2 diabetes. The study subjects: 58 patients with type 2 diabetes and 30 healthy individuals. The research method: cross-sectional description. Results: SSR waves were present in 100% of the healthy control group. Among the 58 diabetic patients, SSR was absent in 52% of those with diabetic peripheral neuropathy (DPN) complications and in 18.2% of those without clinically diagnosed DPN, with an odds ratio (OR) of 4.9, which was statistically significant (95% confidence interval [CI] from 1.5 to 15.9, not including 1). The absence of SSR was not correlated with factors such as age, gender, body mass index (BMI), history of hypertension, lipid metabolism disorders, smoking status, or blood glucose control. However, it was associated with the duration of diabetes, with a higher rate of SSR absence observed in patients who had been diagnosed with diabetes for a longer period of time. Additionally, SSR was often absent in patients with autonomic dysfunction symptoms (65.2%), such as sweating disorders, urinary disorders, erectile dysfunction, orthostatic hypotension, and arrhythmias, with an OR of 17.1, which was statistically significant (95% CI from 4.3 to 67.7). Therefore, SSR can be a valuable technique in supporting the early detection of diabetic neuropathy.