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Diabetes Care. 2020 Feb 6. pii: dc191583. doi: 10.2337/dc19-1583. [Epub ahead of print]

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

Collaborators (571)

Weinstock R, Izquierdo R, Sheikh U, Conboy P, Bulger J, Bzdick S, Klingensmith G, Banion C, Barker J, Cain C, Nadeau K, Rewers M, Rewers A, Slover R, Steck A, Wadwa P, Zeitler P, Alonso G, Forlenza G, Gerard-Gonzalez A, Green M, Gross S, Majidi S, Messer L, Reznick-Lipina T, Simmons E, Thivener K, Weber I, Willi S, Lipman T, Kucheruk O, Minnock P, Carchidi C, Grant B, Olivos D, DiMeglio L, Hannon T, Evans-Molina C, Hansen D, Pottorff T, Woerner S, Hildinger M, Hufferd R, Newnum A, Purtlebaugh D, Smith L, Wendholt K, Goland R, Gandica R, Williams K, Pollack S, Casciano E, Hochberg J, Uche C, Lee J, Gregg B, Tan M, Ang L, Pop-Busui R, Thomas I, Dhadphale E, Dominowski J, Garrity A, Leone V, Plunkett C, Plunkett B, Monzavi R, Cheung C, Fisher L, Kim M, Miyazaki B, Pitukcheewanont P, Sandstrom A, Austin J, Change N, Raymond J, Ichihara B, Lipton M, Flores Garcia J, Garg S, Michels A, Garcetti R, Gutin R, Polsky S, Shah V, Voelmle M, Myers L, Coe G, Demmitt J, Garcia Reyes Y, Giordano D, Joshee P, Nease E, Nguyen N, Wolfsdorf J, Quinn M, Fontanet C, Mukherjee S, Bethin K, Quattrin T, Majumdar I, Mastrandrea L, Gorman E, House A, Michalovic S, Musial W, Shine B, Ahmann A, Castle J, Joarder F, Aby-Daniel D, Guttmann-Bauman I, Klopfenstein B, Morimoto V, Cady N, Fitch R, DeFrang D, Jahnke K, Patoine C, Raman V, Foster C, Murray M, Brown T, Davis C, Slater H, Langvardt J, Bode B, Boyd J, Johnson J, Newton C, Ownby J, Hosey R, Rastogi N, Winslett B, Hirsch I, DeSantis A, Failor RA, Greenbaum C, Trence D, Trikudanathan S, Khakpour D, Thomson P, Sameshima L, Tordillos C, Clements M, Turpin A, Babar G, Broussard J, Cernich J, Dileepan K, Feldt M, Moore W, Musick T, Patton S, Yan Y, Tsai S, Bedard J, Elrod A, Hester L, Beidelschies M, de la Garza J, Haith E, James J, Ramey E, Slover J, Valentine A, Watkins D, Whisenhunt M, Wierson J, Wilson D, Buckingham B, Maahs D, Prahalad P, Hsu L, Kingman R, Tabatabai I, Liljenquist D, Sulik M, Vance C, Halford J, Funke C, Appiagyei-Dankah Y, Beltz E, Moran K, Starkman H, Cerame B, Chin D, Ebner-Lyon L, Sabanosh K, Silverman L, Wagner C, Cheruvu S, Fox M, Melchionne F, Bergenstal R, Madden M, Martens T, Criego A, Powers M, Carlson A, Beasley S, Olson B, Thomas L, McCann K, Dunnigan S, Ashanti C, Simmons J, Russell W, Jaser S, Kelley J, Brendle F, Williams L, Savin K, Flowers K, Williams G, Hamburger E, Davis A, Hammel B, Cengiz E, Tamborlane W, Weyman K, Van Name M, Patel N, Sherr J, Tichy E, Steffen A, Zgorski M, Carria L, Finnegan J, Duran E, Mehta S, Katz M, Laffel L, Giani E, Snelgrove R, Hanono A, Commissariat P, Griffith J, Atkins A, Harrington K, Kim K, Masclans L, Naik N, Ambler-Osborn L, Schultz A, Cohen C, Anderson B, McGill J, Granados A, Clifton MJ, Hurst S, Kissel S, Recklein C, Kruger D, Bhan A, Brown T, Tassopoulos A, Hailey A, Remtema H, Cushman T, Wintergerst K, Watson S, Kingery S, Rayborn L, Rush H, Foster M, Deuser A, Rodriguez-Luna M, Eubanks S, Rodriguez H, Bollepalli S, Smith L, Shulman D, Jorgensen EV, Eyth E, Brownstein R, Rodriguez J, O'Brian J, Aleppo-Kacmarek G, Hahr A, Molitch M, Muayed E, Toft D, Fulkerson C, Adelman D, Massaro E, Webb K, Peters A, Ruelas V, Harmel M, Daniels M, Forghani N, Flannery T, Reh C, Bhangoo A, Kashmiri H, Montgomery K, Trinh L, Speer H, Lane K, Miller C, Burt Solorzano C, Puskaric J, Benjamin R, Adkins D, Spruill A, Williams C, Tsalikian E, Tansey M, Bansl N, Cabbage J, Coffey J, Bisbee R, Schatz D, Clare-Salzler M, Cusi K, Fudge B, Haller M, Meehan C, Rohrs H, Silverstein J, Walker A, Albanese-O'Niell A, Foss S, Adams J, Cintron M, Thomas N, Gottschalk M, Newfield R, Hashiguchi M, Sparling D, Tryggested J, Beck J, Less J, Weber L, Adi S, Gitelman S, Sanda S, Wong J, McDonnell M, Mueller M, Izadi Z, Mistry S, Nelson B, Looper L, Frost C, Redondo M, Lyons S, Klinepeter S, Fegan-Bohm K, Bacha F, DeSalvo D, Butler A, Hilliard M, Khetani F, Yulatic R, Hudson R, Irvine L, Zubair S, Pace C, Pitrello A, Levy W, Njoku C, Zipf W, Dyer J, Lozano R, Seiple D, Corven G, Jaycox M, Wood J, Macleish S, Gubitosi-Klug R, Adams R, McGuigan P, Casey T, Campbell W, Kittelsrud J, Gupta A, Peterson V, Libman I, Diaz A, Jelley D, Crowder C, Greer D, Crawford J, Goudeau S, Pihoker C, Yi-Frazier J, Kearns S, Pascual M, Loots B, Beauregard N, Rickels M, O'Brien S, Agarwal S, Peleckis A, Dalton-Bakes C, Markmann E, Umpierrez G, Muir A, Ramos C, Behbahani K, Dhruv N, Gartzman N, Nathan B, Bellin M, Sunni M, Flaherty N, Leschyshyn J, Schmid K, Weingartner D, Ludwig M, Nelson B, Kogler A, Bartyzal A, Street A, Pappenfus B, Sweet J, Buse J, Young L, Bergamo K, Goley A, Kirkman M, Diner J, Kass A, Dezube M, Arnold K, Evans T, Sellers S, Blackman S, Abel KL, Rasbach L, Ali O, Wolfgram P, Fiallo-Sharer R, Kramer J, Beesley C, Bingham-Tyson C, Unteutsh R, Harlan D, Lee M, Soyka L, Feldman P, Thompson M, Gallagher-Dorval K, Hubacz L, Hartigan C, Ciccarelli C, Edelen R, Edelen M, Borgwadt T, Stauffacher K, DeGrote K, Gruetzmacher C, Shepperd M, Bhargava A, Wright D, Fitzgerald K, Khoo T, Young N, Borg L, Stifel K, Rail C, Casas L, Eidenshink E, Huber C, Rieder A, Tuchscherer A, Broadbent M, Dolan L, Corathers S, Kichler J, Sheanon N, Baugh H, Standiford D, Weis T, Fox C, Schultz C, Ritter A, Vendrame F, Blashke C, Matheson D, Sanders-Branca N, Rudolph J, Biersdorf D, Fitch-Danielson J, Eckerle-Mize D, Fry J, Davis D, Lovell C, Hoffman R, Chaudhari M, Kamboj M, Carr L, Blehm J, Tello A, Walter JA, Ward R, Blomquist G, Stewart M, Cross P, Racki S, Sterchi L, Gouine D, Kiesow B, Welch S, Philis-Tsimikas A, Daily G, Chang A, McCallum J, Garcia I, Vela T, Loupasi I, Rosal R, Toschi E, Middelbeek R, Munshi M, Slyne C, Atakov-Castillo A, Fox L, Mauras N, Wasserman R, Damaso L, Englert K, Sikes K, Ponthieux K, Phillipson L, Cohen A, Gannon G, Deeb L, Shiver A, Schroeder L, Schworm W, Graham K, Levy C, Lam D, Burtman E, Levister C, Ogyaadu S, Gassner H, Duke J, Touger L, Newbern D, Hoekstra F, Harwood K, Prasad V, Daguanno J, Pratley R, Corbin K, Wright M, Nagel S, Water N, Ghere M, Whitaker K, Heptulla R, Katikaneni R, Johnson-Newell D, Crandall J, Powell D, Anghel V, Ghanny S, Aisenberg J, Chartoff A, Sivitz J, Mathus S, Cospito TL, Thailkill K, Fowlkes J, Kalaitzoglou E, Morales Pozzo A, Edwards K.

Abstract

OBJECTIVE:

To evaluate the contemporary prevalence of diabetic peripheral neuropathy (DPN) in type 1 diabetes participants 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 age 39 ± 18 years, median type 1 diabetes duration 18 [interquartile range 11, 31] years, 55% female, 88% non-Hispanic white, mean glycated hemoglobin [HbA1c] 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 HbA1c, longer duration of diabetes, were more likely to be female, and 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 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.

PMID:
32029635
DOI:
10.2337/dc19-1583

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