PREVALENCE OF DIABETIC PERIPHERAL NEUROPATHY AND ITS RELATION TO GLYCEMIC CONTROL AND POTENTIAL RISK-FACTORS - THE EURODIAB IDDM COMPLICATIONS STUDY

The EURODIAB IDDM Complications Study involved the examination of 3250 randomly se lected insulin-dependent diabetic patients, from 31 centr es in 16 European countries. Part of the examination included an asses sment of neurological function including neuropathic symptoms and phys ical signs, vibration perception threshold, tests of autonomic functio n and the prevalence of impotence. The prevalence of diabetic neuropat hy across Europe was 28 % with no significant geographical differences . Significant correlations were observed between the presence of diabe tic peripheral neuropathy with age (p < 0.05), duration of diabetes (p < 0.001), quality of metabolic control (p < 0.001), height (p < 0.01) , the presence of background or proliferative diabetic retinopathy (p < 0.01), cigarette smoking (p < 0.001), high-density lipoprotein chole sterol (p < 0.001) and the presence of cardiovascular disease (p < 0.0 5), thus confirming previous associations. New associations have been identified from this study - namely with elevated diastolic blood pres sure (p < 0.05), the presence of severe ketoacidosis (p < 0.001), an i ncrease in the levels of fasting triglyceride (p < 0.001), and the pre sence of microalbuminuria (p < 0.01). All the data were adjusted for a ge, duration of diabetes and HbA(1c). Although alcohol intake correlat ed with absence of leg reflexes and autonomic dysfunction, there was n o overall association of alcohol consumption and neuropathy. The repor ted problems of impotence were extremely variable between centres, sug gesting many cultural and attitudinal differences in the collection of such information in different European countries. In conclusion, this study has identified previously known and new potential risk factors for the development of diabetic peripheral neuropathy.