Abstract
Aims
To estimate the prevalence and risk factors of diabetic neuropathy in newly diagnosed
type 2 diabetes in general practices.
Methods
Longitudinal data from nationwide general practices in Germany (n = 630) and UK (n = 100) (Disease Analyzer) were analyzed. Patients with newly diagnosed (<1 year) type 2 diabetes (2008–2012) were identified including 45,633 patients (age:
66, SD: 12 years) in Germany and 14,205 patients (age: 63, SD: 13 years) in UK. Neuropathy was identified by ICD code (E11.4) or the original diagnosis.
Associations of potential risk factors with neuropathy were investigated using logistic
regression.
Results
The prevalence of diagnosed neuropathy was 5.7% (95% CI: 5.5–5.9%) in Germany and
2.4% (1.9–2.9%) in UK. In Germany, factors independently associated with neuropathy
in stepwise logistic regression were age (>70 years: OR; 95% CI 2.1; 1.6–2.8), retinopathy
(3.0; 2.1–4.2), peripheral artery disease (PAD: 1.9; 1.4–2.5), insulin treatment (4.6;
3.5–6.2) and oral antidiabetic drugs (OAD: 1.6; 1.2–2.0). In UK, male sex (1.4; 1.01–1.9),
nephropathy (1.7; 1.2–2.5), PAD (1.5; 1.1–2.1), antihypertensives (1.7; 1.1–2.5),
insulin (2.1; 1.1–3.8) and OAD (1.4; 1.01–1.8) were identified.
Conclusions
The prevalence of diabetic neuropathy at time of type 2 diabetes diagnosis was low
in primary care (Germany, UK). Neuropathy was associated with age, PAD and microvacular
complications.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Primary Care DiabetesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Diabetic neuropathies: a statement by the American Diabetes Association.Diabetes Care. 2005; 28: 956-962
- Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments.Diabetes Care. 2010; 33: 2285-2293
- Prediabetes: a high-risk state for diabetes development.Lancet. 2012; 379: 90-2279
- Postchallenge hyperglycemia is positively associated with diabetic polyneuropathy: the KORA F4 study.Diabetes Care. 2012; 35: 1891-1893
- The clinical characteristics at diagnosis of type 2 diabetes in a multi-ethnic population: the South London Diabetes cohort (SOUL-D).Diabetologia. 2013; 56: 81-1272
- Prevalence of peripheral and autonomic neuropathy in newly diagnosed type II (noninsulin-dependent) diabetes.J. Diabet. Complications. 1991; 5: 1-5
- Prevalence and risk factors for diabetic microvascular complications in newly diagnosed type II diabetes mellitus Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS, report 27).J. Diabet. Complications. 2012; 26: 123-128
- Prevalence of neuropathy in newly diagnosed NIDDM and nondiabetic control subjects.Diabetes. 1989; 38: 13-1307
- Validity and representativeness of the Disease Analyzer patient database for use in pharmacoepidemiological and pharmacoeconomic studies.Int. J. Clin. Pharm. Therap. 2009; 47: 617-626
- Diabetic retinopathy at diagnosis of type 2 diabetes in the UK: a database analysis.Diabetologia. 2013; 56: 11-109
- Secondary analysis of electronic databases: potentials and limitations. Reply to Asghari S, Mahdavian M [letter].Diabetologia. 2013; 56: 9-2098
- Older subjects with diabetes and prediabetes are frequently unaware of having distal sensorimotor polyneuropathy: the KORA F4 study.Diabetes Care. 2013; 36: 6-1141
- Are type 2 diabetic patients offered adequate foot care? The role of physician and patient characteristics.J. Diabet. Complications. 2005; 19: 27-319
- Effect of a physician-directed educational campaign on performance of proper diabetic foot exams in an outpatient setting.J. Gen. Intern. Med. 2003; 18: 65-258
- Impact of a program to improve adherence to diabetes guidelines by primary care physicians.Diabetes Care. 2002; 25: 51-1946
- Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy.Diabetes Metab. Res. Rev. 2012; 1: 8-14
- Diagnosis of diabetic peripheral neuropathy among patients with type 1 and type 2 diabetes in France, Italy Spain, and the United Kingdom.Prim. Care Diabetes. 2007; 1: 129-134
- Diabetic neuropathy in Mauritius: prevalence and risk factors.Diabetes Res. Clin. Pract. 1998; 42: 131-139
- Prevalence of polyneuropathy in pre-diabetes and diabetes is associated with abdominal obesity and macroangiopathy: the MONICA/KORA Augsburg Surveys S2 and S3.Diabetes Care. 2008; 31: 9-464
- Vascular factors predict polyneuropathy in a non-diabetic elderly population.Neurol. Sci. 2013; 34: 62-955
- Vascular risk factors and diabetic neuropathy.N. Engl. J. Med. 2005; 352: 50-341
- Risk factors for severity of diabetic polyneuropathy: intensive longitudinal assessment of the Rochester Diabetic Neuropathy Study cohort.Diabetes Care. 1999; 22: 1479-1486
Article info
Publication history
Published online: February 18, 2014
Accepted:
January 18,
2014
Received in revised form:
November 27,
2013
Received:
October 11,
2013
Identification
Copyright
© 2014 Primary Care Diabetes Europe. Published by Elsevier Inc. All rights reserved.
