Prevalence of diabetic peripheral neuropathy and relation to glycemic control therapies at baseline in the BARI 2D cohort
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Abstract We evaluated the associations between glycemic therapies and prevalence of diabetic peripheral neuropathy (DPN) at baseline among participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial on medical and revascularization therapies for coronary artery disease (CAD) and on insulin‐sensitizing vs. insulin‐providing treatments for diabetes. A total of 2,368 patients with type 2 diabetes and CAD was evaluated. DPN was defined as clinical examination score >2 using the Michigan Neuropathy Screening Instrument (MNSI). DPN odds ratios across different groups of glycemic therapy were evaluated by multiple logistic regression adjusted for multiple covariates including age, sex, hemoglobin A1c (HbA1c), and diabetes duration. Fifty‐one percent of BARI 2D subjects with valid baseline characteristics and MNSI scores had DPN. After adjusting for all variables, use of insulin was significantly associated with DPN (OR = 1.57, 95% CI: 1.15–2.13). Patients on sulfonylurea (SU) or combination of SU/metformin (Met)/thiazolidinediones (TZD) had marginally higher rates of DPN than the Met/TZD group. This cross‐sectional study in a cohort of patients with type 2 diabetes and CAD showed association of insulin use with higher DPN prevalence, independent of disease duration, glycemic control, and other characteristics. The causality between a glycemic control strategy and DPN cannot be evaluated in this cross‐sectional study, but continued assessment of DPN and randomized therapies in BARI 2D trial may provide further explanations on the development of DPN.
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In type 2 diabetes mellitus, enhanced glycemic control has been demonstrated to more modestly reduce the risk of developing diabetic peripheral neuropathy by 5%-9%.
“In type 2 DM, enhanced glycemic control has been demonstrated to more modestly reduce the risk of developing, by DPN 5%–9%.14 15 32”
From Glucose time in range and peripheral neuropathy in type 2 diabetes mellitus and chronic kidney disease (2020) · cites this paper as [14]
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- Authors
- Pop‐Busui, R., Lu, J., Lopes, N., & Jones, T. L. Z.
- Affiliations
- University of Michigan (US)
- University of Pittsburgh (US)
- Universidade de São Paulo (BR)
- National Institutes of Health (US)
- Corresponding author
- Pop‐Busui, Rodica
- Venue
- Journal of the Peripheral Nervous System
- Publisher
- Wiley
- Published
- 2009-03
- Volume
- 14
- Issue
- 1
- Pages
- 1-13
- ISSN
- 1085-9489 (ISSN-L)
- 1529-8027
- PMC
- PMC2692660
- OpenAlex
- W2152877006
- Cited by
- 133
- References
- 35
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 2 · 2023: 10 · 2022: 18 · 2021: 11 · 2020: 8 · 2019: 8 · 2018: 11 · 2017: 12 · 2016: 11 · 2015: 2 · 2014: 4 · 2013: 9 · 2012: 10
- FWCI
- 4.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the Peripheral Nervous System (publishedVersion)
- PubMed (publishedVersion)
- Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000454)
- National Heart, Lung, and Blood Institute (U01HL063804, U01HL061748, U01HL061744, U01HL061746)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- diabetic peripheral neuropathy, glycemic control, type 2 diabetes, coronary artery disease, insulin therapy, sulfonylureas, metformin, thiazolidinediones, insulin sensitizers, BARI 2D trial, Michigan Neuropathy Screening Instrument, prevalence
- MeSH terms
- Adult, Aged, Coronary Artery Bypass, Coronary Artery Disease, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Diabetic Neuropathies, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Male, Metformin, Middle Aged, Neurologic Examination, Sulfonylurea Compounds, Cohort Studies, Prevalence, Logistic Models, Randomized Controlled Trials as Topic, Thiazolidinediones
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