Risk factors for diabetic peripheral neuropathy in adolescents and young adults with type 2 Diabetes

1. Amongst young adults with Type 2 Diabetes, male sex, older age, greater BMI, and poor glycemic control was associated with increased risk of developing diabetic peripheral neuropathy.

Evidence Rating Level: 2

Diabetes mellitus is associated with many macro and microvascular comorbidities in affected individuals, especially when poorly controlled. Amongst them, diabetic peripheral neuropathy (DPN) can have significant impact on patient quality of life. Currently, the data on DPN in youth currently is limited. This study aims to study the prevalence of DPN in youth with type 2 diabetes. This study used the Michigan Neuropathy Screening Instrument (MNSI) and a 10-g monofilament exam annually over about 10 years to assess DPN in participants enrolled in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. The study included 674 participants, of which 35% were male. The mean age of the participants was 14 years old. Patient demographic, nonmetabolic, and metabolic characteristics such as BMI and glycated hemogloblin (HbA1c) levels were additionally collected and used in further analysis. Through Cox proportional hazard regression models, male participants had greater DPN incidence values than female participants (38.5% vs. 27.2% via MNSI-exam, P = 0.002; 14.0% vs. 5.1% via monofilament exam, P = 0.01). As expected, participants with high BMI values and poor glycemic control as measured by higher HbA1c also showed higher DPN incidence. Furthermore, race/ethnicity did not show any significant difference in DPN incidence, though advanced age was additionally associated with greater severity of DPN. Study findings not only further reinforce the importance of early and optimal glycemic control for the minimalization of diabetic neuropathy, but also highlights how DPN can affect youth and adults alike. Further investigation into the mechanisms by which males were at greater risk of developing severe DPN compared to females is additionally warranted.

Click to read the study in Diabetes Care

Image: PD

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