Description

Tesfaye et al identified risk factors associated with development of neuropathy in a patient with diabetes mellitus. This can help identify patients who may benefit from more aggressive monitoring and management. The authors are from the European Diabetes Prospective Complications Study Group representing multiple hospitals across Europe.


 

The patients in the study were insulin-dependent diabetics (based on the fact that an insulin dose is listed as a variable).

 

Risk factors for development of diabetic neuropathy:

(1) presence of cardiovascular disease at baseline evaluation

(2) duration of diabetes

(3) current glycoslated hemoglobin value

(4) increase in the glycoslyated hemoglobin during the followup period

(5) body mass index

(6) history of or current smoking

 

There was overlap in 3 of the risk factors between those who progressed to neuropathy and those who did not (Table 2, page 345). I have arbitrarily selected levels for the implementation at which to confer an increased risk:

(1) duration of diabetes: >= 18 years

(2) current glycosylated hemoglobin: >= 9.0%

(3) body mass index: >= 25 kilograms per square meter

 

Additional risk factors that depend on the model used:

(1) elevated triglycerides

(2) hypertension

(3) any retinopathy

 


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