Abstract
Background: Peripheral neuropathy (PN) is a diabetes complication but also occurs without diabetes. The effect of diabetes on PN is not well quantified. Methods: Subjects ≥ 18 years old had a health exam, including an OGTT for diabetes. Distal sensory PN, assessed using 3 graded Semmes Weinstein monofilaments, was classified as none (felt all filaments), latent (insensate to 1 g filament), clinical [mild (insensate to 10 g) or severe (75 g)]. Associations with PN were assessed using ordinal logistic regression assuming equal coefficients across classes of PN. Results: In 1564 subjects (median age 42 years, 50% women, 58% American Indians), PN was latent or worse in 68.9% (95% CI 66.7-71.2), clinical in 11.2% (CI 9.7-12.9), and associated with male sex, older age, and worse glucose regulation (Figure). Age-sex-race-adjusted prevalence was greater in people with than without diabetes (odds ratio; OR 2.2, CI 1.7-2.8), and in those with diabetes, with longer diabetes duration (OR 1.9 per decade, CI 1.5-2.4) or albuminuria, A/C ≥30 mg/g (OR 2.4, CI 1.6-3.6). In those without clinical PN, latent PN was associated with diabetes (OR 1.7, CI 1.2-2.2), longer diabetes duration (OR 2.2 per decade, CI 1.4-3.5) and albuminuria (OR 1.8, CI 1.0-3.2). Conclusions: Although PN is common in people with no diabetes, diabetes greatly increases its risk. Use of 3 monofilaments rather than 1 adds precision and allows detection of latent PN.