Vascular risk factors and diabetic neuropathy
Open accessAbstract
BACKGROUND: Other than glycemic control, there are no treatments for diabetic neuropathy. Thus, identifying potentially modifiable risk factors for neuropathy is crucial. We studied risk factors for the development of distal symmetric neuropathy in 1172 patients with type 1 diabetes mellitus from 31 centers participating in the European Diabetes (EURODIAB) Prospective Complications Study. METHODS: Neuropathy was assessed at baseline (1989 to 1991) and at follow-up (1997 to 1999), with a mean (+/-SD) follow-up of 7.3+/-0.6 years. A standardized protocol included clinical evaluation, quantitative sensory testing, and autonomic-function tests. Serum lipids and lipoproteins, glycosylated hemoglobin, and the urinary albumin excretion rate were measured in a central laboratory. RESULTS: At follow-up, neuropathy had developed in 276 of 1172 patients without neuropathy at baseline (23.5 percent). The cumulative incidence of neuropathy was related to the glycosylated hemoglobin value and the duration of diabetes. After adjustment for these factors, we found that higher levels of total and low-density lipoprotein cholesterol and triglycerides, a higher body-mass index, higher von Willebrand factor levels and urinary albumin excretion rate, hypertension, and smoking were all significantly associated with the cumulative incidence of neuropathy. After adjustment for other risk factors and diabetic complications, we found that duration of diabetes, current glycosylated hemoglobin value, change in glycosylated hemoglobin value during the follow-up period, body-mass index, and smoking remained independently associated with the incidence of neuropathy. Cardiovascular disease at baseline was associated with double the risk of neuropathy, independent of cardiovascular risk factors. CONCLUSIONS: This prospective study indicates that, apart from glycemic control, the incidence of neuropathy is associated with potentially modifiable cardiovascular risk factors, including a raised triglyceride level, body-mass index, smoking, and hypertension.
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Diet and exercise lifestyle changes have shown benefit in preventing CAN.
“As for DPN, lifestyle modifications with diet and exercise have shown benefit in CAN prevention.631”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [631]
In the multivariate-models discussion (page not provided), the paper says that, apart from medication to bring glucose toward normal levels, no other treatments currently exist to reduce neuropathy progression. It discusses cardiac autonomic neuropathy as a condition associated with systolic blood pressure, but does not report a preventive benefit from diet or exercise. (LLM, conf=0.72)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredRisk factors for the development and progression of diabetic neuropathy include poor glycemic control, duration of diabetes, hypertension, lipid abnormalities, smoking cessation, and obesity.
“Risk factors for the development and progression of diabetic neuropathy include poor glycemic control, duration of diabetes, hypertension, lipid abnormalities, smoking cessation, and obesity.”
From The usefulness of deep tendon reflexes in the diagnosis of lumbar spine diseases: a narrative review (2024) · cites this paper as [37]
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- Authors
- Tesfaye, S., Chaturvedi, N., Eaton, S. E. M., Ward, J. D., Manes, C., Ionescu-Tirgoviste, C., Witte, D. R., & Fuller, J. H.
- Affiliations
- Royal Hallamshire Hospital (GB)
- Imperial College London (GB)
- Papageorgiou General Hospital (GR)
- The Royal Free Hospital (GB)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2005-01-27
- Volume
- 352
- Issue
- 4
- Pages
- 341-350
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2583633419
- Cited by
- 1,323
- References
- 37
- Citations by year
- 2026: 32 · 2025: 58 · 2024: 62 · 2023: 74 · 2022: 67 · 2021: 82 · 2020: 87 · 2019: 80 · 2018: 71 · 2017: 54 · 2016: 67 · 2015: 56 · 2014: 75 · 2013: 73 · 2012: 56
- FWCI
- 35.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- diabetic neuropathy, type 1 diabetes, cardiovascular risk factors, HbA1c, glycemic control, triglycerides, body mass index, smoking, hypertension, von Willebrand factor, urinary albumin excretion rate, LDL cholesterol, cardiovascular disease
- MeSH terms
- Adult, Cardiovascular Diseases, Cholesterol, Diabetes Mellitus, Type 1, Diabetic Neuropathies, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Male, Prospective Studies, Risk Factors, Smoking, Triglycerides, Body Mass Index, Multivariate Analysis, Logistic Models
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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