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Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes

Current Diabetes Reports volume 19, Article number: 86 (2019) Cite this article

Abstract

Purpose of Review

Diabetic peripheral neuropathy eventually affects nearly 50% of adults with diabetes during their lifetime and is associated with substantial morbidity including pain, foot ulcers, and lower limb amputation. This review summarizes the epidemiology, risk factors, and management of diabetic peripheral neuropathy and related lower extremity complications.

Recent Findings

The prevalence of peripheral neuropathy is estimated to be between 6 and 51% among adults with diabetes depending on age, duration of diabetes, glucose control, and type 1 versus type 2 diabetes. The clinical manifestations are variable, ranging from asymptomatic to painful neuropathic symptoms. Because of the risk of foot ulcer (25%) and amputation associated with diabetic peripheral neuropathy, aggressive screening and treatment in the form of glycemic control, regular foot exams, and pain management are important. There is an emerging focus on lifestyle interventions including weight loss and physical activity as well.

Summary

The American Diabetes Association has issued multiple recommendation statements pertaining to diabetic neuropathies and the care of the diabetic foot. Given that approximately 50% of adults with diabetes will be affected by peripheral neuropathy in their lifetime, more diligent screening and management are important to reduce the complications and health care burden associated with the disease.

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Acknowledgments

We thank Dr. Andrew Boulton for his review of and insights regarding this manuscript.

Funding

Dr. Selvin was supported by grants K24 DK106414 and R01 DK089174 from the National Institutes of Health (NIDDK) related to this topic.

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Authors and Affiliations

  1. Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Halsted 668, Baltimore, MD, 21287, USA

    Caitlin W. Hicks

  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument St., Suite 2-600, Baltimore, MD, 21287, USA

    Elizabeth Selvin

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  1. Caitlin W. Hicks
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Correspondence to Elizabeth Selvin.

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Caitlin W. Hicks declares that she has no conflict of interest. Elizabeth Selvin is a PI of grants from the Foundation for the National Institutes of Health and the National Kidney Foundation, but that is unrelated to this topic.

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This article is part of the Topical Collection on Microvascular Complications—Neuropathy

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Hicks, C.W., Selvin, E. Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Curr Diab Rep 19, 86 (2019). https://doi.org/10.1007/s11892-019-1212-8

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