Youth-onset male diabetics with poor glycemic control at high risk of neuropathy: Study
Findings from a recent study in the journal Diabetes Care have raised concerns over the long-term development of neuropathy-related morbidity in those with youth-onset type 2 diabetes. According to the study, diabetic peripheral neuropathy (DPN) was evident early in the course of youth-onset type 2 diabetes and increased over time. It was found to be higher in males and related to blood sugar control.
Amongst young adults with type 2 diabetes, male sex, older age, greater BMI, and poor glycemic control were associated with increased risk of developing diabetic peripheral neuropathy.
Laure El ghormli and the colleagues aimed to examine the relationship of glycemic control, sex, race/ethnicity, BMI, and other type 2 diabetes-associated factors with the DPN development in youth with type 2 diabetes enrolled in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study.
For this purpose, the researchers annually performed the Michigan Neuropathy Screening Instrument (MNSI) and a 10-g monofilament exam. DPN was defined as a score (>2) on the MNSI-exam or combined MNSI-exam and MNSI-survey scores (exam >2 and/or survey ≥4), or monofilament exam (<8 of 10 correct responses) at two or more consecutive visits.
The study evaluated a total of 674 participants (35% male), with a mean age of 14 years and diabetes duration <2 years at study entry annually over an average of 10.2 years.
The study yielded the following findings:
- Male subjects had a significantly higher cumulative incidence of DPN than female subjects (38.5% vs. 27.2% via MNSI-exam; 14.0% vs. 5.1% via monofilament exam).
- Rates did not differ by race/ethnicity.
- Higher HbA1c and BMI were associated with higher DPN, by both MNSI and the monofilament test.
- In multivariable models, male sex, older age, and higher BMI were associated with MNSI-exam DPN risk.
'These findings raise concern for the long-term development of neuropathy-related morbidity in youth with type 2 diabetes and the need to achieve improved glycemic control," concluded the authors.
Reference:
Risk Factors for Diabetic Peripheral Neuropathy in Adolescents and Young Adults With Type 2 Diabetes: Results From the TODAY Study TODAY Study Group Diabetes Care Oct 2021, dc211074; DOI: 10.2337/dc21-1074
