Diabetic Neuropathy Is a Substantial Burden in People With Type 1 Diabetes and Is Strongly Associated With Socioeconomic Disadvantage: A Population-Representative Study From Scotland
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. We analyzed data from a large representative sample of adults with T1D ( = 5...
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| Veröffentlicht in: | Diabetes care 2020-04, Vol.43 (4), p.734-742 |
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| creator | Jeyam, Anita McGurnaghan, Stuart J Blackbourn, Luke A K McKnight, John M Green, Fiona Collier, Andrew McKeigue, Paul M Colhoun, Helen M |
| description | 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.
We analyzed data from a large representative sample of adults with T1D (
= 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.
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 |
| doi_str_mv | 10.2337/dc19-1582 |
| format | Article |
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We analyzed data from a large representative sample of adults with T1D (
= 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.
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 m
). 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.
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.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc19-1582</identifier><identifier>PMID: 31974100</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Adolescent ; Adult ; Cholesterol ; Complications ; Cross-Sectional Studies ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (insulin dependent) ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - epidemiology ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetic Neuropathies - epidemiology ; Diabetic Neuropathies - etiology ; Diabetic neuropathy ; Female ; Glomerular filtration rate ; Glucose monitoring ; Health risk assessment ; High density lipoprotein ; Hip ; Humans ; Lipids ; Male ; Middle Aged ; Peripheral neuropathy ; Population studies ; Prevalence ; Regression analysis ; Regression models ; Renal function ; Research design ; Risk analysis ; Risk Factors ; Risk management ; Scotland - epidemiology ; Socio-economic aspects ; Socioeconomic Factors ; Socioeconomics ; Vulnerable Populations - statistics & numerical data ; Young Adult</subject><ispartof>Diabetes care, 2020-04, Vol.43 (4), p.734-742</ispartof><rights>2020 by the American Diabetes Association.</rights><rights>Copyright American Diabetes Association Apr 1, 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-123c86bafa9ed207cde9dc1f2d85e7a9dffc1ae292a375cbcfe79ff47d63acc03</citedby><cites>FETCH-LOGICAL-c348t-123c86bafa9ed207cde9dc1f2d85e7a9dffc1ae292a375cbcfe79ff47d63acc03</cites><orcidid>0000-0001-5220-6244 ; 0000-0001-8701-0233 ; 0000-0002-8345-3288</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31974100$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jeyam, Anita</creatorcontrib><creatorcontrib>McGurnaghan, Stuart J</creatorcontrib><creatorcontrib>Blackbourn, Luke A K</creatorcontrib><creatorcontrib>McKnight, John M</creatorcontrib><creatorcontrib>Green, Fiona</creatorcontrib><creatorcontrib>Collier, Andrew</creatorcontrib><creatorcontrib>McKeigue, Paul M</creatorcontrib><creatorcontrib>Colhoun, Helen M</creatorcontrib><creatorcontrib>SDRNT1BIO Investigators</creatorcontrib><title>Diabetic Neuropathy Is a Substantial Burden in People With Type 1 Diabetes and Is Strongly Associated With Socioeconomic Disadvantage: A Population-Representative Study From Scotland</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>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.
We analyzed data from a large representative sample of adults with T1D (
= 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.
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 m
). 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.
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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Cholesterol</subject><subject>Complications</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetic Neuropathies - epidemiology</subject><subject>Diabetic Neuropathies - etiology</subject><subject>Diabetic neuropathy</subject><subject>Female</subject><subject>Glomerular filtration rate</subject><subject>Glucose monitoring</subject><subject>Health risk assessment</subject><subject>High density lipoprotein</subject><subject>Hip</subject><subject>Humans</subject><subject>Lipids</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Peripheral neuropathy</subject><subject>Population studies</subject><subject>Prevalence</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Renal function</subject><subject>Research design</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Risk management</subject><subject>Scotland - epidemiology</subject><subject>Socio-economic aspects</subject><subject>Socioeconomic Factors</subject><subject>Socioeconomics</subject><subject>Vulnerable Populations - statistics & numerical data</subject><subject>Young Adult</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkctu1TAQhi0EoofCghdAlti0i4BvObHZHVp6kSqoOEUsI8eetK6SOPhSKS_G89VHp2XBajSab_5_ND9C7yn5xDhvPltDVUVryV6gFVW8rupayJdoRahQVa0UO0BvYrwnhAgh5Wt0wKlqBCVkhf6eOt1BcgZ_hxz8rNPdgi8j1nibu5j0lJwe8NccLEzYTfga_DwA_u3SHb5ZZsAU7xWg7Ex2t7pNwU-3w4I3MXrjdAK757el82D85Mfid-qitg_FQN_CF7zB137Og07OT9VPmANEKKPkHqAIZrvgs-BHvDU-DcXnLXrV6yHCu6d6iH6dfbs5uaiufpxfnmyuKsOFTBVl3Mh1p3utwDLSGAuqPKtnVtbQaGX73lANTDHNm9p0podG9b1o7JprYwg_REd73Tn4PxliakcXDQzlBvA5towLwRq5VuuCfvwPvfc5TOW6QslGSFHgQh3vKRN8jAH6dg5u1GFpKWl3Yba7MNtdmIX98KSYuxHsP_I5Pf4I4pmdlQ</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Jeyam, Anita</creator><creator>McGurnaghan, Stuart J</creator><creator>Blackbourn, Luke A K</creator><creator>McKnight, John M</creator><creator>Green, Fiona</creator><creator>Collier, Andrew</creator><creator>McKeigue, Paul M</creator><creator>Colhoun, Helen M</creator><general>American Diabetes Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5220-6244</orcidid><orcidid>https://orcid.org/0000-0001-8701-0233</orcidid><orcidid>https://orcid.org/0000-0002-8345-3288</orcidid></search><sort><creationdate>202004</creationdate><title>Diabetic Neuropathy Is a Substantial Burden in People With Type 1 Diabetes and Is Strongly Associated With Socioeconomic Disadvantage: A Population-Representative Study From Scotland</title><author>Jeyam, Anita ; McGurnaghan, Stuart J ; Blackbourn, Luke A K ; McKnight, John M ; Green, Fiona ; Collier, Andrew ; McKeigue, Paul M ; Colhoun, Helen M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-123c86bafa9ed207cde9dc1f2d85e7a9dffc1ae292a375cbcfe79ff47d63acc03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Cholesterol</topic><topic>Complications</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetic Neuropathies - epidemiology</topic><topic>Diabetic Neuropathies - etiology</topic><topic>Diabetic neuropathy</topic><topic>Female</topic><topic>Glomerular filtration rate</topic><topic>Glucose monitoring</topic><topic>Health risk assessment</topic><topic>High density lipoprotein</topic><topic>Hip</topic><topic>Humans</topic><topic>Lipids</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Peripheral neuropathy</topic><topic>Population studies</topic><topic>Prevalence</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Renal function</topic><topic>Research design</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Risk management</topic><topic>Scotland - epidemiology</topic><topic>Socio-economic aspects</topic><topic>Socioeconomic Factors</topic><topic>Socioeconomics</topic><topic>Vulnerable Populations - statistics & numerical data</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jeyam, Anita</creatorcontrib><creatorcontrib>McGurnaghan, Stuart J</creatorcontrib><creatorcontrib>Blackbourn, Luke A K</creatorcontrib><creatorcontrib>McKnight, John M</creatorcontrib><creatorcontrib>Green, Fiona</creatorcontrib><creatorcontrib>Collier, Andrew</creatorcontrib><creatorcontrib>McKeigue, Paul M</creatorcontrib><creatorcontrib>Colhoun, Helen M</creatorcontrib><creatorcontrib>SDRNT1BIO Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jeyam, Anita</au><au>McGurnaghan, Stuart J</au><au>Blackbourn, Luke A K</au><au>McKnight, John M</au><au>Green, Fiona</au><au>Collier, Andrew</au><au>McKeigue, Paul M</au><au>Colhoun, Helen M</au><aucorp>SDRNT1BIO Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diabetic Neuropathy Is a Substantial Burden in People With Type 1 Diabetes and Is Strongly Associated With Socioeconomic Disadvantage: A Population-Representative Study From Scotland</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2020-04</date><risdate>2020</risdate><volume>43</volume><issue>4</issue><spage>734</spage><epage>742</epage><pages>734-742</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><abstract>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.
We analyzed data from a large representative sample of adults with T1D (
= 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.
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 m
). 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.
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.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>31974100</pmid><doi>10.2337/dc19-1582</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5220-6244</orcidid><orcidid>https://orcid.org/0000-0001-8701-0233</orcidid><orcidid>https://orcid.org/0000-0002-8345-3288</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetes care, 2020-04, Vol.43 (4), p.734-742 |
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| subjects | Adolescent Adult Cholesterol Complications Cross-Sectional Studies Diabetes Diabetes mellitus Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - epidemiology Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - epidemiology Diabetic Neuropathies - epidemiology Diabetic Neuropathies - etiology Diabetic neuropathy Female Glomerular filtration rate Glucose monitoring Health risk assessment High density lipoprotein Hip Humans Lipids Male Middle Aged Peripheral neuropathy Population studies Prevalence Regression analysis Regression models Renal function Research design Risk analysis Risk Factors Risk management Scotland - epidemiology Socio-economic aspects Socioeconomic Factors Socioeconomics Vulnerable Populations - statistics & numerical data Young Adult |
| title | Diabetic Neuropathy Is a Substantial Burden in People With Type 1 Diabetes and Is Strongly Associated With Socioeconomic Disadvantage: A Population-Representative Study From Scotland |
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