Abstract

Objective: To assess associations between peripheral sensory neuropathy (PSN) and other diabetes-related complications.

Research Design and Method: In an area-based cohort of type 2 diabetes we investigated 156 subjects, age 61.7 ± 7.2 years, diabetes duration of 7.0 ± 5.7 years by questionnaires, clinical examinations, blood and urine sampling and by review of medical records.

Results: Prevalence of PSN assessed by monofilament and neurothesiometer, increased with severity of retinopathy, (50% frequency in moderate, 100% in severe or proliferative retinopathy, p=0.02). Vibration Perception Threshold (VPT) was higher in subjects with retinopathy 25.6 ± 8.9 vs. 20.5 ± 8.9 (V), p=0.007. PSN was more common in overt nephropathy with higher VPT than in subjects without overt nephropathy. Subjects with PSN and no retinopathy had twice as much peripheral vascular disease (PVD) (52%PVD), as subjects with PSN in conjunction with retinopathy (19%PVD), p=0.05. In subjects with PSN alone PVD was increased three-fold (52%PVD) compared with no PSN (16%PVD), p=0.001. In multivariate analyse PSN was independently associated with PVD, OR 2.31 p=0.007, age, OR 1.12 p=0.008, male OR 2.01 p=0.02, HDLc, OR 0.21 p<0.05, and tended to be independently associated with IGFBP-1, OR 1.03 p=0.05, but not with diabetes duration or HbA1c.

Conclusions: In a representative population of type 2 diabetes, PSN is related to microvascular or macrovascular pathology. PSN is possibly affected by the IGF-axis.