Association of comorbidities with increasing severity of peripheral neuropathy in diabetes mellitus

AIM: To analyze a large population of patients with diabetes and peripheral neuropathy (PN) to determine other meaningful comorbid etiologies for PN. METHODS: Peripheral Neuropathy is a common complication of type 1 and 2 diabetes mellitus; however, other potential causes for PN may be co-existing in patients with diabetes. A prospective cohort study was performed to assess patients with diabetes and PN. We compared patients having PN due solely to diabetes with patients possessing co-existing comorbidities, performing clinical (Toronto Clinical Scoring System and the Utah Early Neuropathy Scale), laboratory and electrophysiological assessments in all patients. RESULTS: Patients with either type 1 or 2 diabetes mellitus and co-existing comorbidities did not have more severe clinical or electrophysiological PN phenotypes overall. However, in patients with type 1 diabetes, presence of a lipid disorder was associated with greater PN severity. In type 2 diabetes patients, both a lipid disorder and cobalamin deficiency were associated with greater PN severity. There was no additive effect upon PN severity with presence of three or more comorbid etiologies. CONCLUSION: The presence of specific, and not general, comorbidities in patients with type 1 or 2 diabetes corresponds with greater PN severity. (C) 2013 Baishideng. All rights reserved.