Diabetic polyneuropathy (DPN), diabetic retinopathy (DR) and diabetic nephropathy are widely classified as microvascular complications of diabetes. DPN, which may cause complete sensation loss, is another common complication of DM. The DPN-related diminished sensation presents a significant risk factor for subsequent diabetic ulcers and non-traumatic amputations. The prevalence rate of diabetic neuropathic pain is approximately 10-20% among the diabetic population, and approximately 40-60% in patients with documented neuropathy. The purpose of this study was to assess the relationship between DPN and the risk of DR. From 1997 to 2010, 5031 newly diagnosed DPN patients and 20,124 controls matched for sex, age and index year, were identified. The adjusted hazard ratio was calculated and adjusted for age, sex, duration of diabetes and comorbidities of hypertension, cardiovascular disease and diabetic nephropathy. The incidence rate of DR was 5.87-fold higher in the DPN patients than in the non-DPN group, with an adjusted HR of 5.41 (95% CI = 4.92–5.94). The DPN-to-non-DPN DR incidence rate ratio decreased with age. Compared with the non-DPN group, the DPN patients had a 5.63-fold risk of non-proliferative DR and a 3.67- fold risk of proliferative DR. 

Diabetic polyneuropathy and the risk of developing diabetic retinopathy: a nation-wide, population-based study.
Lin IC, Wang YH, Lin CL, et al.
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Bheemanagouda Patil

Waikato Hospital, Hamilton, New Zealand

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