Risk factors for diabetic peripheral sensory neuropathy. Results of the Seattle Prospective Diabetic Foot Study

• Published in: Diabetes care Vol. 20; no. 7; pp. 1162 - 1167
• Main Authors: ADLER, A. I, BOYKO, E. J, AHRONI, J. H, STENSEL, V, FORSBERG, R. C, SMITH, D. G
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.07.1997
• Subjects: Age Factors; Aged; Alcohol Drinking - adverse effects; Associated diseases and complications; Biological and medical sciences; Blood Glucose - analysis; Body Height; Cohort Studies; Diabetes Complications; Diabetes Mellitus - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic Neuropathies - epidemiology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Follow-Up Studies; Humans; Incidence; Logistic Models; Male; Medical sciences; Middle Aged; Peripheral Nervous System - physiopathology; Peripheral Nervous System Diseases - epidemiology; Prevalence; Prospective Studies; Risk Factors; Sensory Thresholds - physiology; Veterans - statistics & numerical data; Washington - epidemiology; Washington; Endocrinopathy; Human; Nervous system diseases; Diabetes mellitus; Sensory polyneuropathy; Risk factor; Lower limb; Complication; Peripheral nerve disease; Peripheral neuropathy; Epidemiology
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.20.7.1162

Risk factors for diabetic peripheral sensory neuropathy. Results of the Seattle Prospective Diabetic Foot Study. A I Adler , E J Boyko , J H Ahroni , V Stensel , R C Forsberg and D G Smith Northwest Health Services Research and Development Program, Veterans Administration Puget Sound Health Care System, University of Washington, Seattle, USA. amanda.adler@clinical-medicine.oxford.ac.uk Abstract OBJECTIVE: To identify risk factors for diabetic lower-extremity peripheral sensory neuropathy prospectively in a cohort of U.S. veterans with diabetes. RESEARCH DESIGN AND METHODS: General medicine clinic outpatients with diabetes were followed prospectively for the development of insensitivity to the 5.07 monofilament on the foot. RESULTS: Of 775 subjects, 388 (50%) had neuropathy at baseline. Of the 387 subjects without neuropathy at baseline, 288 were followed up, and of these, 58 (20%) developed neuropathy. Multivariate logistic regression modeling of prevalent neuropathy controlling for sex and race revealed independent and significant associations with age, duration of diabetes, glycohemoglobin level, height, history of lower-extremity ulceration, callus, and edema; an independent and inverse correlation was noted with ankle-arm index. Risk factors for incident neuropathy in multivariate logistic regression included age, baseline glycohemoglobin level, height, history of ulcer, and CAGE screening instrument alcohol score; current smoking and albumin level were inversely associated with risk. CONCLUSIONS: Poorer glycemic control increases the risk of neuropathy and is amenable to intervention. Height and age directly increase risk of neuropathy and may help identify patients at risk. A proportion of neuropathy in diabetic veterans is probably due to or worsened by alcohol ingestion. Neuropathy was less common in current smokers than subjects not currently smoking.