SAN DIEGO — Diabetic peripheral neuropathy was the most common microvascular complication among people with diabetes who underwent a comprehensive annual diabetes assessment, Robyn Anderson reported in a poster session at the annual scientific sessions of the American Diabetes Association.
“We expected to see more retinopathy, but this was a fairly healthy population [of people with diabetes],” said Ms. Anderson, an epidemiologist with the International Diabetes Center, Minneapolis.
“These were people coming in for a 3-hour comprehensive diabetes visit, so we recruited from that pool. They were already very motivated patients, to come in and get help.” She also noted that 84% of the patients had type 2 diabetes, “so if there had been a higher prevalence of type 1, it's possible we may have detected more retinopathy.”
In a study led by Mary L. Johnson, a registered nurse at the center, Ms. Anderson and her associates evaluated 206 patients for microvascular complications during their annual diabetes visit. Their mean age was 57 years, more than half (54%) were female, and their average hemoglobin A1c level was 7.3%.
The investigators collected data on hemoglobin A1c, lipids, and microalbuminuria, and they also conducted several screenings including the nonmydriatic retinal photo, nerve conduction tests, the Michigan Neuropathy Screening Instrument (MNSI), the vibration detection threshold (VDT), and Neuropathy Total Symptom Score-6.
They defined diabetic peripheral neuropathy as an MNSI score of greater than 2.0 plus either VDT greater than or equal to the 95th percentile or abnormal nerve conduction. Complete data were available for 166 of the 206 patients.
The investigators identified microvascular complications in 48% of patients.
The 10-g microfilament test identified 16% of patients who screened positive for diabetic peripheral neuropathy, yet about twice as many (31%) met the clinical definition of diabetic peripheral neuropathy. At the same time, symptoms of diabetic peripheral neuropathy were observed in 63% of all patients.
Nephropathy was found in 20% of patients and diabetic retinopathy was identified in 11% of patients.
In their poster, the investigators wrote that the observations “support more extensive and systematic screening for diabetic peripheral neuropathy (including both symptoms and clinical exam) in addition to 10-g microfilament exam in diabetes patients with and without known diabetic microvascular complications.”
Eli Lilly & Co. sponsored the study.