Interoceptive disorders in patients with diabetes mellitus

Abstract

Introduction: Interoceptive is the body's ability to perceive visceral sensations and physiological state, and can directly or indirectly influence awareness and behavior. Diabetic autonomic neuropathy is among the least known and understood complications of diabetes, despite significant negative impact on quality of life and of causing neurovegetative disorders. Internal body state has an extensive influence on brain function and mental activity, including affective state. Determining a correlation between the autonomic nervous system, interoceptive and affective state, we can understand the effect of chronic diseases, like diabetes, on the perception and mental state of the patient and vice versa. Purpose and Objective: The detection of neurovegetative disorders in patients with diabetes and their influence on interoception as well as the emotional state. Materials and methods: In this study participated 40 pacients with diabetes mellitus in association with polyneuropathy - DZ and two reference groups: 10 healthy individuals as control group- S and 20 patients with chronic migraine -M. All of them were women. For the study of interoception we used Stephen W. Porges BODY PERCEPTION questionnaire, Ph.D. 2003, modified, shortened to 50 questions. Motor autonomic profile (PVM -2 prof. Ion Moldovanu) to determine neurovegetative disorders. Additional scale represents an interpretation of data extracted from PVM, which refers to bodily sensations (interoceptive and exteroceptive) and affective disorders. Symptoms of anxiety and depression were screened using the Hospital Anxiety and Depression Scale (HADS). Results: (1) Hypertension and low blood sugar prevail in patients with diabetes compared with reference groups (M and S) (P<0.05). (2) Influence of chronic migraine on the occurrence of menstrual disorders is higher than that of diabetes (P<0.05). (3) Patients with diabetes compared to healthy people, have a higher number of symptoms related to cardiovascular dysfunction in subscales: visceral interoception, visceral pain, musculoskeletal interoception, musculo-skeletal pain (P<0.05). (4) Affective disorders in patients with diabetes are more expressed compared to healthy individuals (P<0.05). (5) HADS scale results showed that the impact of interoceptive disorders on anxiety is as significant as the influence of anxiety on the ability of perception. Conclusion: In this study we determine a correlation between interoceptive disorders and affective disorders. It can be assumed that the intensification of perception of bodily sensations in patients with diabetes occurs through the affective disorders.