OBJECTIVE To evaluate the contemporary prevalence of diabetic peripheral neuropathy (DPN) in participants with type 1 diabetes in the T1D Exchange Clinic Registry throughout the U.S. RESEARCH DESIGN AND METHODS DPN was assessed with the Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ) in adults with ≥5 years of type 1 diabetes duration. A score of ≥4 defined DPN. Associations of demographic, clinical, and laboratory factors with DPN were assessed. RESULTS Among 5,936 T1D Exchange participants (mean ± SD age 39 ± 18 years, median type 1 diabetes duration 18 years [interquartile range 11, 31], 55% female, 88% non-Hispanic white, mean glycated hemoglobin [HbA1c] 8.1 ± 1.6% [65.3 ± 17.5 mmol/mol]), DPN prevalence was 11%. Compared with those without DPN, DPN participants were older, had higher HbA1c, had longer duration of diabetes, were more likely to be female, and were less likely to have a college education and private insurance (all P < 0.001). DPN participants also were more likely to have cardiovascular disease (CVD) (P < 0.001), worse CVD risk factors of smoking (P = 0.008), hypertriglyceridemia (P = 0.002), higher BMI (P = 0.009), retinopathy (P = 0.004), reduced estimated glomerular filtration rate (P = 0.02), and Charcot neuroarthropathy (P = 0.002). There were no differences in insulin pump or continuous glucose monitor use, although DPN participants were more likely to have had severe hypoglycemia (P = 0.04) and/or diabetic ketoacidosis (P < 0.001) in the past 3 months. CONCLUSIONS The prevalence of DPN in this national cohort with type 1 diabetes is lower than in prior published reports but is reflective of current clinical care practices. These data also highlight that nonglycemic risk factors, such as CVD risk factors, severe hypoglycemia, diabetic ketoacidosis, and lower socioeconomic status, may also play a role in DPN development.

中文翻译：

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1 型糖尿病中糖尿病神经病变的当代患病率：来自 T1D Exchange 的发现。


目的 评估整个美国 T1D 交换诊所登记处 1 型糖尿病参与者中糖尿病周围神经病变 (DPN) 的当代患病率 研究设计和方法 使用密歇根神经病变筛查仪器问卷 (MNSIQ) 对 ≥5 岁成人的 DPN 进行评估1 型糖尿病病程年数。 ≥4 分定义为 DPN。评估了人口统计学、临床和实验室因素与 DPN 的关联。结果 在 5,936 名 T1D Exchange 参与者中（平均 ± 标准差，年龄 39 ± 18 岁，中位 1 型糖尿病病程 18 年 [四分位距 11, 31]，55% 女性，88% 非西班牙裔白人，平均糖化血红蛋白 [HbA1c] 8.1 ± 1.6% [65.3 ± 17.5 mmol/mol])，DPN 患病率为 11%。与没有 DPN 的参与者相比，DPN 参与者年龄更大，HbA1c 更高，糖尿病病程更长，女性的可能性更大，并且不太可能拥有大学教育和私人保险（所有 P < 0.001）。 DPN 参与者也更有可能患有心血管疾病 (CVD) (P < 0.001)、吸烟等更严重的 CVD 危险因素 (P = 0.008)、高甘油三酯血症 (P = 0.002)、较高的 BMI (P = 0.009)、视网膜病变 (P = 0.004）、估计肾小球滤过率降低（P = 0.02）和夏科神经关节病（P = 0.002）。尽管 DPN 参与者在过去 3 个月内更有可能出现严重低血糖 (P = 0.04) 和/或糖尿病酮症酸中毒 (P < 0.001)，但胰岛素泵或连续血糖监测仪的使用没有差异。结论 该全国 1 型糖尿病队列中 DPN 的患病率低于之前发表的报告，但反映了当前的临床护理实践。 这些数据还强调，非血糖危险因素，如 CVD 危险因素、严重低血糖、糖尿病酮症酸中毒和较低的社会经济地位，也可能在 DPN 的发展中发挥作用。