Comparison of diabetic and idiopathic sensory polyneuropathies with respect to nerve fibre affection and risk factors

Mustapha Itani*, Sif Gylfadottir, Thomas Krøigård, Laura Gaist, Jakob Vormstrup Holbech, Alexander Gramm Kristensen, Pall Karlsson, Sören Möller, Hatice Tankisi, David Gaist, Troels S. Jensen, Nanna Brix Finnerup, Søren Hein Sindrup

*Corresponding author for this work

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Background and purpose Chronic distal sensory or sensorimotor polyneuropathy is the most common pattern of polyneuropathy. The cause of this pattern is most often diabetes or unknown. This cross-sectional study is one of the first studies to compare the demographics, cardiovascular risk factors and clinical characteristics of diabetic polyneuropathy (DPN) with idiopathic polyneuropathy (IPN). Methods Patients with DPN were included from a sample of 389 patients with type 2 diabetes mellitus (T2DM) enrolled from a national cohort of patients with recently diagnosed T2DM (Danish Centre for Strategic Research in Type 2 Diabetes cohort). Patients with IPN were included from a regional cohort of patients with symptoms of polyneuropathy referred for workup at a combined secondary and tertiary neurological centre (database cohort). Results A total of 214 patients with DPN were compared with a total of 88 patients with IPN. Patients with DPN were older (67.4 vs 59 years) and had a longer duration of neuropathy symptoms. Patients with DPN had greater body mass index (32 vs 27.4 kg/m 2) and waist circumference (110 cm vs 97 cm); higher frequency of hypertension diagnosis (72.9% vs 30.7%); lower total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels; and a higher prevalence of use of statins (81.8% vs 19.3%). DPN was associated with a slightly higher autonomic score and total score on the Neuropathy Symptom Score; lower frequency of hyperalgesia, allodynia and decreased vibration on quantitative sensory testing; lower intraepidermal nerve fibre density count and higher frequency of small-fibre neuropathy. Conclusion DPN and IPN showed clear differences in neuropathy characteristics, indicating that these two entities are to be regarded as aetiologically and pathogenetically distinct.

Original languageEnglish
Article numbere000247
JournalBMJ Neurology Open
Issue number1
Number of pages10
Publication statusPublished - 14. Mar 2022

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  • diabetes
  • diabetic neuropathy
  • neuropathy
  • neurophysiol, clinicaL


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