Is Peripheral Neuropathy Associated With Retinopathy and Albuminuria in Individuals With Impaired Glucose Metabolism?
The 1999–2000 AusDiab
- Elizabeth L.M. Barr, MPH1,
- Tien Y. Wong, MD, PHD12,
- Robyn J. Tapp, PHD1,
- C. Alex Harper, MD2,
- Paul Z. Zimmet, MD, PHD1,
- Robert Atkins, MSC, MD3,
- Jonathan E. Shaw, MD1 and
- on behalf of the AusDiab Steering Committee
- 1International Diabetes Institute, Melbourne, Australia
- 2Centre for Eye Research, University of Melbourne, Melbourne, Australia
- 3Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
- Address correspondence and reprint requests to Tien Yin Wong, MD, PhD, Centre for Eye Research Australia, University of Melbourne, 32 Gisborne St., Victoria 3002, Australia. E-mail: twong{at}unimelb.edu.au
- AusDiab, Australian, Diabetes, Obesity, and Lifestyle Study
- IFG, impaired fasting glucose
- IGT, impaired glucose tolerance
- NDS, neuropathy disability score
- NSS, neuropathy symptom score
- PPS, pressure perception score
Individuals with impaired glucoses tolerance (IGT) or impaired fasting glucose (IFG) are at substantially increased risk of developing diabetes and cardiovascular disease (1). The extent to which individuals with IGT/IFG are also at risk of microvascular complications, such as neuropathy, retinopathy, and nephropathy, has not been as well defined. Some (2,3), but not all (4–7), studies have shown that microvascular complications are more common in individuals with IGT/IFG than those with normal glucose metabolism.
Peripheral neuropathy, a common microvascular complication of diabetes (8), is often associated with concomitant retinopathy (9) and albuminuria (9,10). Whether peripheral neuropathy is also associated with retinopathy and albuminuria in people with IGT/IFG is unclear and is examined in the current study.
RESEARCH DESIGN AND METHODS
The Australian, Diabetes, Obesity, and Lifestyle Study (AusDiab) is a population-based survey of Australian adults aged ≥25 years (11). Glucose tolerance status was determined by a 75-g oral glucose tolerance test (12). The prevalence of diabetes in the AusDiab was 7.4%, while 16.4% had IGT or IFG (13). All participants with diabetes, IGT, IFG, and a random sample of normal control subjects were invited for complications testing (6). This analysis is based on the 1,154 individuals with IGT or IFG who attended the complications screening.
Neuropathy was classified by 1) the modified neuropathy symptom score (NSS), 2) the modified neuropathy disability score (NDS), 3) the pressure perception score (PPS), and 4) a postural systolic blood pressure drop score of ≥20 mmHg. The NSS measured …
