Clinical, Neuropathic, and Sudomotor Correlates of Orthostatic Hypotension in Type 2 Diabetes: A Cross-Sectional Study
Abstract
Background/Objectives: Orthostatic hypotension (OH) is a clinically relevant manifestation that may reflect cardiovascular autonomic dysfunction in type 2 diabetes (T2D), yet its correlates remain incompletely characterized. This cross-sectional study evaluated clinical, neuropathic, and sudomotor factors associated with OH and explored balance-related outcomes as secondary analyses. Methods: In this cross-sectional study, 124 adults with T2D aged ≥60 years underwent standardized orthostatic blood pressure testing. Peripheral neuropathy was assessed using the Michigan Neuropathy Screening Instrument (MNSI), and sudomotor function was assessed by electrochemical skin conductance measured with Sudoscan. Balance, mobility, and fear of falling were evaluated as exploratory secondary outcomes. Active antihypertensive treatment was recorded at the time of assessment and considered a potential confounder. Multivariable logistic regression was used to identify factors associated with OH. Results: OH was associated with longer diabetes duration (OR = 1.11/year, p = 0.002), higher objective neuropathy severity (MNSI-B; OR = 1.27, p = 0.049), and increased urinary albumin-to-creatinine ratio (OR = 1.01, p = 0.035). Sudomotor parameters did not differ significantly between OH groups in univariate analyses and were not retained in the final parsimonious model. Exploratory analyses showed no significant univariate differences in balance or fear-of-falling outcomes by OH status. Model…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 124 participants or records.
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