As many as 70% of people with diabetes are estimated to have some form of neuropathy, or nerve damage. And now, new research published in the journal Diabetes Care suggests that roughly a quarter of young people with Type 2 diabetes have the condition.
As part of the ongoing SEARCH for Diabetes in Youth study, researchers looked at data from 399 youths with diabetes, all of whom had been diagnosed before they turned 20. The 329 participants with Type 1 diabetes had an average age of 15.7, while the 70 participants with Type 2 had an average age of 21.6. Those with Type 2 had a higher body-mass index (a measure of weight relative to height), waist circumference, blood fat levels, and blood pressure than those with Type 1, but A1C levels (a measure of blood glucose levels over the previous 2–3 months) did not differ significantly between the two groups.
The researchers used an evaluation known as the Michigan Neuropathy Screening Instrument (MNSI), which involves both a questionnaire and a multipart physical assessment, to determine how many of the participants had neuropathy. The results showed that 8.2% of the youths with Type 1 and 25.7% of the youths with Type 2 were experiencing diabetic peripheral neuropathy. (By comparison, approximately 30% to 70% of adults with diabetes have the condition, according to the study authors.)
The youth who had neuropathy were significantly older, with a longer duration of diabetes, greater waist circumference, higher blood pressure levels, poorer lipid levels, and more microalbuminuria (protein in the urine) than those who did not have neuropathy. A1C levels, however, were not significantly different between those with and without neuropathy, at 9.0% and 8.8%, respectively.
Although the odds for diabetic neuropathy were nearly four times greater among those with Type 2 diabetes, this difference was no longer significant after adjustment for factors such as diabetes duration, blood pressure, and waist circumference.
“Diabetic peripheral neuropathy is an early and significant complication of diabetes in [youths with] both types 1 and 2. Because of the significant disability brought on by [this, including] pain, poor quality of life, ulcers, and amputations, it is essential that physicians be aware that diabetic peripheral neuropathy can occur early,” lead study investigator Eva L. Feldman, MD, PhD, noted in an interview with Medscape Medical News.
“Early diagnosis of diabetic peripheral neuropathy combined with improved diabetes control, improved control of dyslipidemia and hypertension, and lifestyle interventions can significantly improve diabetic peripheral neuropathy outcomes,” she added.
The researchers suggest that simple screening procedures for neuropathy, such as testing the perception of vibration and light touch on the big toe and checking for the presence of ankle reflexes, are critical. The American Diabetes Association recommends that children and adolescents with Type 2 diabetes be screened at diagnosis and that children and adolescents with Type 1 diabetes be screened five years after diagnosis.
The investigators are in the process of collecting data on more young people with diabetes to get a better sense of the risk factors for developing diabetic neuropathy.
To learn more about the research, read the article “Peripheral Neuropathy Common in Youth With Type 2 Diabetes” (free registration is required) or see the study’s abstract in the journal Diabetes Care. And to learn more about coping with painful neuropathy, click here.