Vascular Risk Factors and Diabetic Neuropathy

Apart from glycemic control, there is no treatment for diabetic neuropathy. Thus, identifying potentially modifiable risk factors is crucial for the development of new therapies. In addition to glycemic control, the incidence of neuropathy in type 1 diabetes is associated with potentially modifiable cardiovascular risk factors including a raised triglyceride level, body-mass index, smoking, and hypertension. Diabetic neuropathy is a common cause of morbidity and death among patients with diabetes, generating a huge economic burden. 1 Apart from tight glycemic control, no other evidence-based treatments are known to ameliorate or prevent neuropathy. The duration and level of hyperglycemia are important determinants of microvascular complications of diabetes, including neuropathy. 2 The relative effect of cardiovascular risk factors specifically associated with diabetes (e.g., hypertension, dyslipidemia, and increased weight) or not associated with diabetes (smoking) on the development of neuropathy are incompletely elucidated. The Diabetes Control and Complications Trial (DCCT) reported a 60 percent reduction in neuropathy in the intensively treated . . .