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- Title
Protection from neuropathy in extreme duration type 1 diabetes.
- Authors
Azmi, Shazli; Ferdousi, Maryam; Kalteniece, Alise; Petropoulos, Ioannis N.; Ponirakis, Georgios; Alam, Uazman; Asghar, Omar; Marshall, Andrew; Sankar, Adhithya; Boulton, Andrew J. M.; Soran, Handrean; Efron, Nathan; Malik, Rayaz A.
- 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.
- Subjects
GLYCOSYLATED hemoglobin; GLOMERULAR filtration rate; ALBUMINS; TRIGLYCERIDES; SENSES; BLOOD pressure; NEURONS; DIABETIC neuropathies; PERONEAL nerve; MICROSCOPY; TYPE 1 diabetes; LOW density lipoproteins; COMPARATIVE studies; NEURAL conduction; DISEASE duration; DESCRIPTIVE statistics; VIBRATION (Mechanics); HEART beat; ALCOHOL drinking; HIGH density lipoproteins; BODY mass index; PHENOTYPES; CREATININE; CHOLESTEROL; LONGITUDINAL method; DISEASE complications; MIDDLE age; OLD age
- Publication
Journal of the Peripheral Nervous System, 2021, Vol 26, Issue 1, p49
- ISSN
1085-9489
- Publication type
Article
- DOI
10.1111/jns.12423