Protection from neuropathy in extreme duration type 1 diabetes


Azmi, Shazli, Ferdousi, Maryam, Kalteniece, Alise, Petropoulos, Ioannis N, Ponirakis, Georgios, Alam, Uazman ORCID: 0000-0002-3190-1122, Asghar, Omar, Marshall, Andrew ORCID: 0000-0001-8273-7089, Sankar, Adhithya, Boulton, Andrew JM et al (show 3 more authors) (2021) Protection from neuropathy in extreme duration type 1 diabetes JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, 26 (1). pp. 49-54. ISSN 1085-9489, 1529-8027

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Abstract

A proportion of individuals with type 1 diabetes mellitus for more than 50 years (medallists) may be protected from developing nephropathy, retinopathy and neuropathy. Detailed neuropathy phenotyping was undertaken in a cohort of 33 medallists aged 63.7 ± 1.4 years with diabetes for 58.5 ± 0.8 years and HbA1c of 65.9 ± 2.1 mmol/mmol. Medallists had a significantly higher HbA1c (P <.001), lower estimated glomerular filtration rate (eGFR) (P =.005) and higher albumin creatinine excretion ratio (ACR) (P =.01), but a lower total cholesterol (P <.001), triacylglycerols (P =.001), low density lipoprotein-cholesterol (P <.001) and higher high density lipoprotein-cholesterol (P =.03), compared to controls. Twenty-four percent of participants were identified as “escapers” without confirmed diabetic neuropathy. They had a lower neuropathy symptom profile (P =.002), vibration perception threshold (P =.02), warm threshold (P =.05), higher peroneal amplitude (P =.005), nerve conduction velocity (P =.03), heart rate variability (P =.001), corneal nerve fibre density (P = 0.001), branch density (P <.001) and length (P =.001), compared to medallists with diabetic neuropathy. Escapers had a shorter duration of diabetes (P =.006), lower alcohol consumption (P =.04), lower total cholesterol (P =.04) and LDL (P =.02), higher eGFR (P =.001) and lower ACR (P <.001). Patients with extreme duration diabetes without diabetic neuropathy have a comparable HbA1c, blood pressure and body mass index, but a more favourable lipid profile and consume less alcohol compared to those with diabetic neuropathy.

Item Type: Article
Uncontrolled Keywords: corneal confocal microscopy, extreme duration diabetes, neuropathy, type 1 diabetes
Depositing User: Symplectic Admin
Date Deposited: 09 Dec 2020 12:01
Last Modified: 16 Jun 2026 15:15
DOI: 10.1111/jns.12423
Open Access URL: https://onlinelibrary.wiley.com/doi/10.1111/jns.12...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3109737
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