The Eurodiab study: what has this taught us about diabetic peripheral neuropathy?

Apart from tight blood glucose control, no other treatments have been shown to retard the progression of diabetic peripheral neuropathy (DPN). Therefore, identifying potential risk factors for DPN is important, particularly if they are modifiable. The Eurodiab baseline DPN study found a prevalence of 28% for DPN, with glycemic control and duration of diabetes being major determinants. It was also observed that a substantial proportion of those with good glucose control (hemoglobin A(1c) < 7%) were found to have DPN, which raised the possibility that other risk factors may be involved. Having excluded those with DPN at baseline, researchers followed 1172 type 1 diabetic subjects for 7.3 years (SD, 0.6) looking for risk factors for the development of DPN. DPN developed in 23.5% over the follow-up period; and apart from glycemic control and duration of diabetes, known to be important risk factors for DPN, traditional markers of macrovascular disease (eg, hypertension, smoking, obesity, and triglycerides) were found to be independent risk factors. The study was published in the New England Journal of Medicine and suggested that a need exists for clinical trials to confirm if modifying cardiovascular risk factors is an effective treatment for DPN.