Anita Jeyam1, Stuart J McGurnaghan2, Luke A K Blackbourn2, John M McKnight3, Fiona Green4, Andrew Collier5, Paul M McKeigue6, Helen M Colhoun. 1. MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, U.K. anita.jeyam@igmm.ed.ac.uk. 2. MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, U.K. 3. Western General Hospital, NHS Lothian, Edinburgh, U.K. 4. Research and Development Support Unit, Dumfries and Galloway Royal Infirmary, Dumfries, U.K. 5. Diabetic Day Centre, University Hospital Ayr, Ayr, U.K. 6. Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, Edinburgh Medical School: Molecular, Genetic and Population Health Sciences, University of Edinburgh, Edinburgh, U.K.
Abstract
OBJECTIVE: To assess the contemporaneous prevalence of diabetic peripheral neuropathy (DPN) in people with type 1 diabetes (T1D) in Scotland and study its cross-sectional association with risk factors and other diabetic complications. RESEARCH DESIGN AND METHODS: We analyzed data from a large representative sample of adults with T1D (N = 5,558). We assessed the presence of symptomatic neuropathy using the dichotomized (≥4) Michigan Neuropathy Screening Instrument Patient Questionnaire score. Logistic regression models were used to investigate associations between DPN and risk factors, as well as with other complications. RESULTS: The burden of DPN is substantial with 13% prevalence overall. Adjusting for attained age, diabetes duration, and sex, the odds of DPN increased mainly with waist-to-hip ratio, lipids, poor glycemic control (odds ratio 1.51 [95% CI 1.21-1.89] for levels of 75 vs. 53 mmol/mol), ever versus never smoking (1.67 [1.37-2.03]), and worse renal function (1.96 [1.03-3.74] for estimated glomerular filtration rate levels <30 vs. ≥90 mL/min/1.73 m2). The odds significantly decreased with higher HDL cholesterol (0.77 [0.66-0.89] per mmol/L). Living in more deprived areas was associated with DPN (2.17 [1.78-2.65]) for more versus less deprived areas adjusted for other risk factors. Finally, individuals with prevalent DPN were much more likely than others to have other diabetes complications. CONCLUSIONS: Diabetic neuropathy remains substantial, particularly affecting those in the most socioeconomically deprived groups. Those with clinically manifest neuropathy also have a higher burden of other complications and elevated levels of modifiable risk factors. These data suggest that there is considerable scope to reduce neuropathy rates and narrow the socioeconomic differential by better risk factor control.
OBJECTIVE: To assess the contemporaneous prevalence of diabetic peripheral neuropathy (DPN) in people with type 1 diabetes (T1D) in Scotland and study its cross-sectional association with risk factors and other diabetic complications. RESEARCH DESIGN AND METHODS: We analyzed data from a large representative sample of adults with T1D (N = 5,558). We assessed the presence of symptomatic neuropathy using the dichotomized (≥4) Michigan Neuropathy Screening Instrument Patient Questionnaire score. Logistic regression models were used to investigate associations between DPN and risk factors, as well as with other complications. RESULTS: The burden of DPN is substantial with 13% prevalence overall. Adjusting for attained age, diabetes duration, and sex, the odds of DPN increased mainly with waist-to-hip ratio, lipids, poor glycemic control (odds ratio 1.51 [95% CI 1.21-1.89] for levels of 75 vs. 53 mmol/mol), ever versus never smoking (1.67 [1.37-2.03]), and worse renal function (1.96 [1.03-3.74] for estimated glomerular filtration rate levels <30 vs. ≥90 mL/min/1.73 m2). The odds significantly decreased with higher HDL cholesterol (0.77 [0.66-0.89] per mmol/L). Living in more deprived areas was associated with DPN (2.17 [1.78-2.65]) for more versus less deprived areas adjusted for other risk factors. Finally, individuals with prevalent DPN were much more likely than others to have other diabetes complications. CONCLUSIONS:Diabetic neuropathy remains substantial, particularly affecting those in the most socioeconomically deprived groups. Those with clinically manifest neuropathy also have a higher burden of other complications and elevated levels of modifiable risk factors. These data suggest that there is considerable scope to reduce neuropathy rates and narrow the socioeconomic differential by better risk factor control.
Authors: Blake Byron Walker; Sebastian Tobias Brinkmann; Tim Große; Dominik Kremer; Nadine Schuurman; Perry Hystad; Sumathy Rangarajan; Koon Teo; Salim Yusuf; Scott A Lear Journal: J Urban Health Date: 2022-05-12 Impact factor: 5.801
Authors: Andreas Höhn; Stuart J McGurnaghan; Thomas M Caparrotta; Anita Jeyam; Joseph E O'Reilly; Luke A K Blackbourn; Sara Hatam; Christian Dudel; Rosie J Seaman; Joseph Mellor; Naveed Sattar; Rory J McCrimmon; Brian Kennon; John R Petrie; Sarah Wild; Paul M McKeigue; Helen M Colhoun Journal: PLoS One Date: 2022-08-11 Impact factor: 3.752
Authors: Rodica Pop-Busui; Jye-Yu C Backlund; Ionut Bebu; Barbara H Braffett; Gayle Lorenzi; Neil H White; John M Lachin; Elsayed Z Soliman Journal: J Diabetes Investig Date: 2021-08-14 Impact factor: 4.232