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.

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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: 18 Jan 2023 23:19
DOI: 10.1111/jns.12423
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