Early diabetic polyneuropathy signals subsequent CVD

Among patients with newly diagnosed type 2 diabetes (T2D), the risk of developing cardiovascular disease (CVD) is elevated in the presence of symptoms indicative of diabetic polyneuropathy (DPN), as shown in a study.

The study linked data from two Danish T2D cohorts, namely the Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen-Detected Diabetes in Primary Care (ADDITION-Denmark) and the Danish Centre for Strategic Research in Type 2 Diabetes (DD2), to national healthcare registers.

A total of 1,445 T2D patients in ADDITION-Denmark and 5,028 in DD2 were included in the analysis. All patients completed the Michigan Neuropathy Screening Instrument questionnaire (MNSIq) at diabetes diagnosis in ADDITION-Denmark and at a median of 4.6 years after diagnosis in DD2. DPN was defined as an MNSIq score of ≥4.

Poisson regression analysis showed that higher MNSIq scores (≥4 vs <4) correlated with an increased incidence rate of CVD. The corresponding incidence rate ratios (IRRs) were 1.79 (95 percent confidence interval [CI] 1.38–2.31) in ADDITION-Denmark, 1.57 (95 percent CI 1.27–1.94) in DD2. The combined IRR was 1.65 (CI 1.41–1.95) in a fixed-effect meta-analysis.

Meanwhile, MNSIq scores ≥4 showed no association with mortality. The combined mortality rate ratio was 1.11 (95 percent CI 0.83–1.48).

The findings underscore that MNSIq may be a useful tool to pinpoint a subgroup within newly diagnosed T2D patients at high-risk of subsequent CVD, beyond that conferred by established CVD risk factors.