Data related to diabetic neuropathy in youth with type 2 diabetes are limited. We examined the relationship of glycemic control, sex, race/ethnicity, BMI, and other type 2 diabetes-associated factors with the development of diabetic peripheral neuropathy (DPN) in youth with type 2 diabetes enrolled in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study.

The Michigan Neuropathy Screening Instrument (MNSI) and a 10-g monofilament exam were performed annually. DPN was defined as a score (>2) on the MNSI-exam or combined MNSI-exam and MNSI-survey scores (exam >2 and/or survey ≥4), or monofilament exam (<8 of 10 correct responses) at two or more consecutive visits. Multivariable time-to-event models assessed the association of risk factors evaluated longitudinally with DPN events.

A total of 674 participants (35% male), with a mean age of 14 years and diabetes duration <2 years at study entry, were evaluated annually over an average of 10.2 years. Male subjects had a significantly higher cumulative incidence of DPN than female subjects (38.5% vs. 27.2% via MNSI-exam, P = 0.002; 14.0% vs. 5.1% via monofilament exam, P = 0.01). Rates did not differ by race/ethnicity. Higher HbA_1c and BMI were associated with higher DPN, by both MNSI and the monofilament test. In multivariable models, male sex, older age, and higher BMI were associated with MNSI-exam DPN risk.

DPN was evident early in the course of youth-onset type 2 diabetes and increased over time. It was higher in male subjects and related to glycemic control. These findings raise concern for long-term development of neuropathy-related morbidity in youth with type 2 diabetes and the need to achieve improved glycemic control.

与 2 型糖尿病青少年糖尿病神经病变相关的数据有限。我们研究了参加 2 型糖尿病治疗方案的 2 型糖尿病青少年的血糖控制、性别、种族/民族、BMI 和其他 2 型糖尿病相关因素与糖尿病周围神经病变 (DPN) 发展的关系。青少年（今日）研究。

每年进行密歇根神经病变筛查仪 (MNSI) 和 10 克单丝检查。 DPN 被定义为 MNSI 考试得分 (>2) 或 MNSI 考试和 MNSI 调查综合得分（考试 >2 和/或调查 ≥4），或单丝考试（10 个正确答案中 <8 分）或连续多次访问。多变量事件发生时间模型评估了纵向评估的危险因素与 DPN 事件之间的关联。

共有 674 名参与者（35% 男性），平均年龄 14 岁，糖尿病病程 <2 id=57>P = 0.002； 14.0% 与单丝检查的 5.1%， P = 0.01）。比率不因种族/民族而异。根据 MNSI 和单丝测试，较高的 HbA _1c和 BMI 与较高的 DPN 相关。在多变量模型中，男性、年龄较大和较高的 BMI 与 MNSI 检查 DPN 风险相关。

DPN 在青少年发病的 2 型糖尿病病程早期就很明显，并且随着时间的推移而增加。男性受试者较高，且与血糖控制有关。这些发现引起了人们对 2 型糖尿病青少年神经病变相关发病率长期发展的关注，以及改善血糖控制的必要性。