Risk Factors for Developing Diabetic Peripheral Neuropathy: a Meta-analysis

Abstract

To identify risk factors for the development of diabetic peripheral neuropathy, systematic searches of PubMed, Embase, Web-of-Science, Cochrane and Google scholar databases were performed to conduct a meta-analysis of prospective studies that quantified major risk factors for diabetic peripheral neuropathy. Two authors independently extracted data for a random-effects meta-analysis. The standardized mean difference (SMD) and 95% CI for continuous data, and an odds ratio (OR) and 95% CI for dichotomous data were calculated. Of 7473 studies retrieved, 16 qualified studies were included. Contributing risk factors for developing diabetic peripheral neuropathy were age (SMD = 0.36; CI, 0.19 to 0.54; P < 0.01), body mass index (SMD = 0.31; CI, 0.20 to 0.42; P < 0.01), diabetes duration (SMD = 0.47; CI, 0.30 to 0.65; P < 0.01), estimated glomerular filtration rate (SMD = − 0.45; CI, − 0.63 to − 0.27; P < 0.01), fibrinogen (SMD = 0.10; CI, 0.01 to 0.19; P = 0.03), haemoglobin A1c (SMD = 0.24; CI, 0.16 to 0.32; P < 0.01), high-density lipoproteins (SMD = − 0.14; CI, − 0.21 to − 0.06; P < 0.01) systolic blood pressure (SMD = 0.31; CI, 0.10 to 0.52; P < 0.01), waist circumference (SMD = 0.39; CI, 0.14 to 0.64; P < 0.01), weight (SMD = 0.34; CI, 0.24 to 0.43; P < 0.01), cardiovascular disease (OR = 2.22; CI, 1.75 to 2.81; P < 0.01), foot ulcer history (OR = 1.90; CI, 1.09 to 3.33; P = 0.02), hypertension (OR = 1.90; CI, 1.24 to 2.89; P < 0.01), macroalbuminuria (OR = 2.96; CI, 2.02 to 4.35; P < 0.01), micro- or macroalbuminuria (OR = 1.73; CI, 1.43 to 2.08; P < 0.01), proliferative retinopathy (OR = 2.48; CI, 1.80 to 3.41; P < 0.01) and retinopathy (OR = 2.19; CI, 1.84 to 2.62; P < 0.01). Our findings show 17 risk factors that significantly contribute to the development of diabetic peripheral neuropathy.

Time to diabetic neuropathy and its predictors among adult type 2 diabetes mellitus patients in Amhara regional state Comprehensive Specialized Hospitals, Northwest Ethiopia, 2022: A retrospective follow up study

“…The hazard of developing Diabetic neuropathy among type two diabetic patients with retinopathy was higher than in type two DM patients without diabetic retinopathy. This finding is consistent with the findings of studies conducted in Sri Lanka [21], Netherlands [39], Jordan [40], Singapore [41], and china [28]. The clinical stages of diabetic retinopathy, the ongoing disturbance of the neurovascular unit, and the loss of auto-regulation may all be to blame for this.…”

“…previous studies conducted in Gamo Gofa, Ethiopia [26], Tanzania [21], Burkina Faso [44], and Netherland [39]. This might be due to inflammation, oxidative stress, activation of the immune system, thickening of the blood vessels which results reduce blood flow to the nerve, conduction slowing, and axonal atrophy [45].…”

The Relationship between Hba1c Levels and Body Mass Index with Severity of Diabetic Neuropathy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

“…Increasing HbA1c levels will further accelerate and exacerbate neuropathy complications. [15][16][17][18][19] Meanwhile, the relationship between body mass index and the severity of diabetic neuropathy in this study was found to have no significant relationship.…”

The Interpretable Multimodal Machine Learning (IMML) framework reveals pathological signatures of distal sensorimotor polyneuropathy

“…The neurological comorbidity status of patients is not used to classify DSPN yet, however, there might be an intrinsic neurological mechanism that links DSPN to other neurological illnesses. Finally, waist circumference is strongly correlated with BMI, which has been reported to be a risk factor for developing DSPN 29 . From a clinical perspective it is worth mentioning that only waist circumference represents a modifiable risk factor which emphasises the role of obesity prevention and treatment also in the context of DSPN.…”