Nonglycemic factors up risk for peripheral neuropathy in T1DM

(HealthDay)—Several nonglycemic factors may increase the risk for the development of diabetic peripheral neuropathy (DPN) among people with type 1 diabetes (T1D), according to a study recently published in Diabetes Care.

Kara R. Mizokami-Stout, M.D., from the University of Michigan in Ann Arbor, and colleagues measured the prevalence of DPN in 5,936 adults in the United States with T1D who participated in the T1D Exchange Clinic Registry. The researchers assessed DPN prevalence using the Michigan Neuropathy Screening Instrument Questionnaire in adults who have had T1D for at least five years and characterized these results using demographic, clinical, and laboratory data.

The researchers found that 11 percent of survey participants have DPN. DPN was associated with patients who were older, female, had higher glycated hemoglobin, and who had T1D for a longer duration. Individuals with DPN were also less likely to have a college education and private insurance. Cardiovascular disease (CVD) and CVD risk factors, including smoking, hypertriglyceridemia, and higher body mass index, retinopathy, reduced estimated glomerular filtration rate, and Charcot neuroarthropathy, were more common for patients with DPN. People with DPN were also more likely to have had severe hypoglycemia (SH) and/or diabetic ketoacidosis (DKA).

"The prevalence of DPN in this national cohort with type 1 diabetes is lower than prior published reports but is reflective of current clinical care practices," the authors write. "Although we confirmed expected associations between DPN and traditional glycemic and vascular risk factors, we have also found associations with novel nonglycemic DPN risk factors, such as CVD risk factors, both SH and DKA, potentially reflecting effects of glycemic variability, and lower socioeconomic status, highlighting the importance of social determinants of health in patients with type 1 diabetes."

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