The Contemporary Prevalence of Diabetic Neuropathy in Type 1 Diabetes: Findings From the T1D Exchange.

Autor: Mizokami-Stout KR; Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI., Li Z; Jaeb Center for Health Research, Tampa, FL., Foster NC; Jaeb Center for Health Research, Tampa, FL t1dstats3@jaeb.org., Shah V; Barbara Davis Center for Diabetes, Denver, CO., Aleppo G; Northwestern University Feinberg School of Medicine, Chicago, IL., McGill JB; Washington University School of Medicine in St. Louis, St. Louis, MO., Pratley R; AdventHealth Translational Research Institute for Metabolism and Diabetes, Orlando, FL., Toschi E; Joslin Diabetes Center, Harvard Medical School, Boston, MA., Ang L; Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI., Pop-Busui R
Jazyk: angličtina
Zdroj: Diabetes care [Diabetes Care] 2020 Apr; Vol. 43 (4), pp. 806-812. Date of Electronic Publication: 2020 Feb 06.
DOI: 10.2337/dc19-1583
Abstrakt: Objective: To evaluate the contemporary prevalence of diabetic peripheral neuropathy (DPN) in participants with type 1 diabetes in the T1D Exchange Clinic Registry throughout the U.S.
Research Design and Methods: DPN was assessed with the Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ) in adults with ≥5 years of type 1 diabetes duration. A score of ≥4 defined DPN. Associations of demographic, clinical, and laboratory factors with DPN were assessed.
Results: Among 5,936 T1D Exchange participants (mean ± SD age 39 ± 18 years, median type 1 diabetes duration 18 years [interquartile range 11, 31], 55% female, 88% non-Hispanic white, mean glycated hemoglobin [HbA 1c ] 8.1 ± 1.6% [65.3 ± 17.5 mmol/mol]), DPN prevalence was 11%. Compared with those without DPN, DPN participants were older, had higher HbA 1c , had longer duration of diabetes, were more likely to be female, and were less likely to have a college education and private insurance (all P < 0.001). DPN participants also were more likely to have cardiovascular disease (CVD) ( P < 0.001), worse CVD risk factors of smoking ( P = 0.008), hypertriglyceridemia ( P = 0.002), higher BMI ( P = 0.009), retinopathy ( P = 0.004), reduced estimated glomerular filtration rate ( P = 0.02), and Charcot neuroarthropathy ( P = 0.002). There were no differences in insulin pump or continuous glucose monitor use, although DPN participants were more likely to have had severe hypoglycemia ( P = 0.04) and/or diabetic ketoacidosis ( P < 0.001) in the past 3 months.
Conclusions: The prevalence of DPN in this national cohort with type 1 diabetes is lower than in prior published reports but is reflective of current clinical care practices. These data also highlight that nonglycemic risk factors, such as CVD risk factors, severe hypoglycemia, diabetic ketoacidosis, and lower socioeconomic status, may also play a role in DPN development.
(© 2020 by the American Diabetes Association.)
Databáze: MEDLINE
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