Prospective study of neuropathic symptoms preceding clinically diagnosed diabetic polyneuropathy: Addition-Denmark

Laura L. Määttä, Morten Charles, Daniel R. Witte, Lasse Bjerg, Marit E. Jørgensen, Troels Staehelin Jensen, Signe T. Andersen*

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE To evaluate whether diabetic polyneuropathy (DPN) follows the hypothesis for the course of nerve fiber damage reflected by symptoms progressing from pure small through mixed to large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers. RESEARCH DESIGN AND METHODS Repeated assessments of nerve fiber–specific symptoms were obtained in 518 participants of the ADDITION-Denmark study from the time of a screening-based diagnosis of type 2 diabetes using specific items of the Michigan Neuropathy Screening Instrument questionnaire. DPN was clinically assessed 13 years after inclusion. The course of symptoms reflecting dysfunction of specific nerve fibers was evaluated, and the association between symptoms and DPN was estimated using logistic regression models. RESULTS An overall stable, yet heterogeneous course of symptoms was seen. According to the hypothesis of symptom progression, 205 (40%) participants remained free of symptoms and 56 (11%) had stable, 114 (23%) progressing, and 132 (26%) improving symptoms. Cross-sectional estimates showed a higher risk of DPN (odds ratios between 2.1 and 4.1) for participants with mixed or large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers compared with participants without symptoms. CONCLUSIONS There was no evidence for a progressive development of nerve fiber damage in DPN reflected by symptoms going from pure small through mixed to large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers. Yet overall, neuropathic symptoms were prospectively associated with a higher risk of DPN.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind42
Udgave nummer12
Sider (fra-til)2282-2289
ISSN0149-5992
DOI
StatusUdgivet - 1. dec. 2019

Fingeraftryk

Diabetic Neuropathies
Denmark
Nerve Fibers
Prospective Studies
Logistic Models
Type 2 Diabetes Mellitus
Odds Ratio

Citer dette

Määttä, L. L., Charles, M., Witte, D. R., Bjerg, L., Jørgensen, M. E., Jensen, T. S., & Andersen, S. T. (2019). Prospective study of neuropathic symptoms preceding clinically diagnosed diabetic polyneuropathy: Addition-Denmark. Diabetes Care, 42(12), 2282-2289. https://doi.org/10.2337/dc19-0869
Määttä, Laura L. ; Charles, Morten ; Witte, Daniel R. ; Bjerg, Lasse ; Jørgensen, Marit E. ; Jensen, Troels Staehelin ; Andersen, Signe T. / Prospective study of neuropathic symptoms preceding clinically diagnosed diabetic polyneuropathy : Addition-Denmark. I: Diabetes Care. 2019 ; Bind 42, Nr. 12. s. 2282-2289.
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title = "Prospective study of neuropathic symptoms preceding clinically diagnosed diabetic polyneuropathy: Addition-Denmark",
abstract = "OBJECTIVE To evaluate whether diabetic polyneuropathy (DPN) follows the hypothesis for the course of nerve fiber damage reflected by symptoms progressing from pure small through mixed to large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers. RESEARCH DESIGN AND METHODS Repeated assessments of nerve fiber–specific symptoms were obtained in 518 participants of the ADDITION-Denmark study from the time of a screening-based diagnosis of type 2 diabetes using specific items of the Michigan Neuropathy Screening Instrument questionnaire. DPN was clinically assessed 13 years after inclusion. The course of symptoms reflecting dysfunction of specific nerve fibers was evaluated, and the association between symptoms and DPN was estimated using logistic regression models. RESULTS An overall stable, yet heterogeneous course of symptoms was seen. According to the hypothesis of symptom progression, 205 (40{\%}) participants remained free of symptoms and 56 (11{\%}) had stable, 114 (23{\%}) progressing, and 132 (26{\%}) improving symptoms. Cross-sectional estimates showed a higher risk of DPN (odds ratios between 2.1 and 4.1) for participants with mixed or large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers compared with participants without symptoms. CONCLUSIONS There was no evidence for a progressive development of nerve fiber damage in DPN reflected by symptoms going from pure small through mixed to large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers. Yet overall, neuropathic symptoms were prospectively associated with a higher risk of DPN.",
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Prospective study of neuropathic symptoms preceding clinically diagnosed diabetic polyneuropathy : Addition-Denmark. / Määttä, Laura L.; Charles, Morten; Witte, Daniel R.; Bjerg, Lasse; Jørgensen, Marit E.; Jensen, Troels Staehelin; Andersen, Signe T.

I: Diabetes Care, Bind 42, Nr. 12, 01.12.2019, s. 2282-2289.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Prospective study of neuropathic symptoms preceding clinically diagnosed diabetic polyneuropathy

T2 - Addition-Denmark

AU - Määttä, Laura L.

AU - Charles, Morten

AU - Witte, Daniel R.

AU - Bjerg, Lasse

AU - Jørgensen, Marit E.

AU - Jensen, Troels Staehelin

AU - Andersen, Signe T.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - OBJECTIVE To evaluate whether diabetic polyneuropathy (DPN) follows the hypothesis for the course of nerve fiber damage reflected by symptoms progressing from pure small through mixed to large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers. RESEARCH DESIGN AND METHODS Repeated assessments of nerve fiber–specific symptoms were obtained in 518 participants of the ADDITION-Denmark study from the time of a screening-based diagnosis of type 2 diabetes using specific items of the Michigan Neuropathy Screening Instrument questionnaire. DPN was clinically assessed 13 years after inclusion. The course of symptoms reflecting dysfunction of specific nerve fibers was evaluated, and the association between symptoms and DPN was estimated using logistic regression models. RESULTS An overall stable, yet heterogeneous course of symptoms was seen. According to the hypothesis of symptom progression, 205 (40%) participants remained free of symptoms and 56 (11%) had stable, 114 (23%) progressing, and 132 (26%) improving symptoms. Cross-sectional estimates showed a higher risk of DPN (odds ratios between 2.1 and 4.1) for participants with mixed or large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers compared with participants without symptoms. CONCLUSIONS There was no evidence for a progressive development of nerve fiber damage in DPN reflected by symptoms going from pure small through mixed to large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers. Yet overall, neuropathic symptoms were prospectively associated with a higher risk of DPN.

AB - OBJECTIVE To evaluate whether diabetic polyneuropathy (DPN) follows the hypothesis for the course of nerve fiber damage reflected by symptoms progressing from pure small through mixed to large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers. RESEARCH DESIGN AND METHODS Repeated assessments of nerve fiber–specific symptoms were obtained in 518 participants of the ADDITION-Denmark study from the time of a screening-based diagnosis of type 2 diabetes using specific items of the Michigan Neuropathy Screening Instrument questionnaire. DPN was clinically assessed 13 years after inclusion. The course of symptoms reflecting dysfunction of specific nerve fibers was evaluated, and the association between symptoms and DPN was estimated using logistic regression models. RESULTS An overall stable, yet heterogeneous course of symptoms was seen. According to the hypothesis of symptom progression, 205 (40%) participants remained free of symptoms and 56 (11%) had stable, 114 (23%) progressing, and 132 (26%) improving symptoms. Cross-sectional estimates showed a higher risk of DPN (odds ratios between 2.1 and 4.1) for participants with mixed or large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers compared with participants without symptoms. CONCLUSIONS There was no evidence for a progressive development of nerve fiber damage in DPN reflected by symptoms going from pure small through mixed to large nerve fiber symptoms with or without symptoms of loss of function of small nerve fibers. Yet overall, neuropathic symptoms were prospectively associated with a higher risk of DPN.

U2 - 10.2337/dc19-0869

DO - 10.2337/dc19-0869

M3 - Journal article

C2 - 31558545

AN - SCOPUS:85075813289

VL - 42

SP - 2282

EP - 2289

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 12

ER -