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Prevalence of Distal Symmetrical Polyneuropathy by Diabetes Prevention Program Treatment Group, Diabetes Status, Duration of Diabetes, and Cumulative Glycemic Exposure.

Collaborators (666)

Author information

Affiliations

  • 1. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
      Authors
    • Lee CG 1
    (1 author)
  • 2. Biostatistics Center and Milken Institute School of Public Health, The George Washington University, Rockville, MD.
      Authors
    • Ciarleglio A 2
    • Edelstein SL 2
    • Knowler WC 2
    (3 authors)
  • 3. Division of Endocrinology and Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, NY.
      Authors
    • Crandall JP 3
    (1 author)
  • 4. University of Colorado Anschutz Medical Campus, Aurora, CO.
      Authors
    • Dabelea D 4
    (1 author)
  • 5. University of Miami Leonard M. Miller School of Medicine, Miami, FL.
      Authors
    • Goldberg RB 5
    (1 author)
    • Show all (8)

ORCIDs linked to this article

Diabetes Care, 01 May 2024, 47(5):810-817
https://doi.org/10.2337/dc23-2009 PMID: 38502874 

Free full text available after 01 May 2025

Abstract 

Objective

To assess associations between distal symmetric polyneuropathy (DSPN) and Diabetes Prevention Program (DPP) treatment groups, diabetes status or duration, and cumulative glycemic exposure approximately 21 years after DPP randomization.

Research design and methods

In the DPP, 3,234 adults ≥25 years old at high risk for diabetes were randomized to an intensive lifestyle (ILS), metformin, or placebo intervention to prevent diabetes. After the DPP ended, 2,779 joined the Diabetes Prevention Program Outcomes Study (DPPOS). Open-label metformin was continued, placebo was discontinued, ILS was provided in the form of semiannual group-based classes, and all participants were offered quarterly lifestyle classes. Symptoms and signs of DSPN were assessed in 1,792 participants at DPPOS year 17. Multivariable logistic regression models were used to evaluate DSPN associations with treatment group, diabetes status/duration, and cumulative glycemic exposure.

Results

At 21 years after DPP randomization, 66% of subjects had diabetes. DSPN prevalence did not differ by initial DPP treatment assignment (ILS 21.5%, metformin 21.5%, and placebo 21.9%). There was a significant interaction between treatment assignment to ILS and age (P < 0.05) on DSPN. At DPPOS year 17, the odds ratio for DSPN in comparison with ILS with placebo was 17.4% (95% CI 3.0, 29.3) lower with increasing 5-year age intervals. DSPN prevalence was slightly lower for those at risk for diabetes (19.6%) versus those with diabetes (22.7%) and was associated with longer diabetes duration and time-weighted HbA1c (P values <0.001).

Conclusions

The likelihood of DSPN was similar across DPP treatment groups but higher for those with diabetes, longer diabetes duration, and higher cumulative glycemic exposure. ILS may have long-term benefits on DSPN for older adults.

Full text links 

Read article at publisher's site: https://doi.org/10.2337/dc23-2009

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NIDDK NIH HHS (24)

National Institute of Diabetes and Digestive and Kidney Diseases (22)