Nancy Cardinez1, Leif E Lovblom1, Johnny-Wei Bai1, Evan Lewis1, Alon Abraham2, Daniel Scarr1, Julie A Lovshin1, Yuliya Lytvyn3, Genevieve Boulet1, Mohammed A Farooqi1, Andrej Orszag1, Alanna Weisman1, Hillary A Keenan4, Michael H Brent5, Narinder Paul6, Vera Bril2, David Z Cherney3, Bruce A Perkins7. 1. Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. 2. Neuromuscular Diseases Unit of the Department of Neurology, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Division of Nephrology, Department of Medicine, University of Toronto, Ontario, Canada. 4. Research Division, Joslin Diabetes Center, Boston, MA, USA; Genzyme Corporation, Cambridge, MA, USA. 5. Department of Ophthalmology and Vision Sciences, Department of Medicine, University of Toronto, Ontario, Canada. 6. Joint Department of Medical Imaging, Division of Cardiothoracic Radiology, University Health Network, Toronto, Ontario, Canada. 7. Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address: bruce.perkins@sinaihealthsystem.ca.
Abstract
AIM: Neuropathy and neuropathic pain are common complications of type 1 diabetes (T1D). We aimed to determine if sex-specific differences in neuropathic pain are present in adults with longstanding T1D. METHODS: Canadians with ≥50 years of T1D (n = 361) completed health history questionnaires that included assessment of neuropathy (defined by Michigan Neuropathy Screening Instrument questionnaire components ≥3; NEUROPATHYMNSI-Q) and neuropathic pain. Multivariable logistic regression was used to determine sex-differences in neuropathic pain controlling for neuropathy. RESULTS: Participants had mean age 66 ± 9 years, median diabetes duration 53[51,58] years, mean HbA1c 7.5 ± 1.0%, and 207(57%) were female. Neuropathic pain was present in 128(36%) of all participants, more prevalent among those with NEUROPATHYMNSI-Q compared to those without [96(63%) vs. 31(15%), p < 0.001], and more prevalent in females compared to males [87(42%) vs. 41(27%), p = 0.003]. Independent of the presence of NEUROPATHYMNSI-Q and other factors, female sex was associated with the presence of neuropathic pain [OR 2.68 (95% CI 1.4-5.0), p = 0.002]. CONCLUSIONS: We demonstrated a novel sex-specific difference in neuropathic pain in females compared to males with longstanding T1D, independent of the presence of neuropathy. Further research using more objective measures of neuropathy than the MNSI is justified to further understand this sex-specific difference.
AIM: Neuropathy and neuropathic pain are common complications of type 1 diabetes (T1D). We aimed to determine if sex-specific differences in neuropathic pain are present in adults with longstanding T1D. METHODS: Canadians with ≥50 years of T1D (n = 361) completed health history questionnaires that included assessment of neuropathy (defined by Michigan Neuropathy Screening Instrument questionnaire components ≥3; NEUROPATHYMNSI-Q) and neuropathic pain. Multivariable logistic regression was used to determine sex-differences in neuropathic pain controlling for neuropathy. RESULTS:Participants had mean age 66 ± 9 years, median diabetes duration 53[51,58] years, mean HbA1c 7.5 ± 1.0%, and 207(57%) were female. Neuropathic pain was present in 128(36%) of all participants, more prevalent among those with NEUROPATHYMNSI-Q compared to those without [96(63%) vs. 31(15%), p < 0.001], and more prevalent in females compared to males [87(42%) vs. 41(27%), p = 0.003]. Independent of the presence of NEUROPATHYMNSI-Q and other factors, female sex was associated with the presence of neuropathic pain [OR 2.68 (95% CI 1.4-5.0), p = 0.002]. CONCLUSIONS: We demonstrated a novel sex-specific difference in neuropathic pain in females compared to males with longstanding T1D, independent of the presence of neuropathy. Further research using more objective measures of neuropathy than the MNSI is justified to further understand this sex-specific difference.
Authors: Kara R Mizokami-Stout; Zoey Li; Nicole C Foster; Viral Shah; Grazia Aleppo; Janet B McGill; Richard Pratley; Elena Toschi; Lynn Ang; Rodica Pop-Busui Journal: Diabetes Care Date: 2020-02-06 Impact factor: 17.152
Authors: Nitin Agarwal; Thomas Fleming; Divija Deshpande; Claire Gaveriaux-Ruff; Christoph S N Klose; Anke Tappe-Theodor; Rohini Kuner; Peter Nawroth Journal: Nat Commun Date: 2021-01-18 Impact factor: 14.919