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Diabetic Peripheral Neuropathy and Urological Complications in Type 1 Diabetes: Findings From the Epidemiology of Diabetes Interventions and Complications Study

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posted on 02.11.2021, 19:08 by Rodica Pop-Busui, Barbara H. Braffett, Hunter Wessells, William H. Herman, Catherine L. Martin, Alan M. Jacobson, Aruna V. Sarma, the DCCT/EDIC Reaserch Group
Objective:
To evaluate associations between diabetic peripheral neuropathy (DPN) and urological complications in men and women with type 1 diabetes.
ResearchDesignandMethods:
Measurements of DPN at EDIC years 1, 13/14 and 17 and urological complications at EDIC year 17 were examined in 635 men (mean age 51.6 yrs, diabetes duration 29.5 yrs) and 371 women (mean age 50.6 yrs and diabetes duration 29.8 yrs) enrolled in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. DPN was defined by symptoms, signs and abnormal electrophysiology, or by abnormal Michigan Neuropathy Screening Instrument (MNSI) examination or questionnaire scores.
Results:
Erectile dysfunction (ED) in combination with lower urinary tract symptoms (LUTS) was reported in 15% of men, and female sexual dysfunction (FSD), LUTS and urinary incontinence (UI) in 16% of women. When controlling for age, drinking status, BMI, depression, DCCT/EDIC time-weighted mean HbA1c, microalbuminuria, hypertension, triglycerides and statin medication use, men with confirmed DPN at EDIC year 13/14 had a higher odds of ED/LUTS at year 17 compared to men without DPN (OR=3.52 95% CI 1.69,7.31). Men with DPN based on abnormal MNSI examination or questionnaire scores had significantly higher odds of ED and LUTS at year 17 than men without DPN at all time points. There were no significant differences in DPN between women reporting both FSD and LUTS/UI compared to those without FSD or LUTS/UI at EDIC year 17.
Conclusions:
In long-standing T1D, DPN is associated with the later development of urological complications in men.

Funding

The DCCT/EDIC has been supported by cooperative agreement grants (1982-1993, 2012-2017, 2017-2022), and contracts (1982-2012) with the Division of Diabetes Endocrinology and Metabolic Diseases of the National Institute of Diabetes and Digestive and Kidney Disease (current grant numbers U01 DK094176 and U01 DK094157), and through support by the National Eye Institute, the National Institute of Neurologic Disorders and Stroke, the General Clinical Research Centers Program (1993-2007), and Clinical Translational Science Center Program (2006-present), Bethesda, Maryland, USA. Additional support for this DCCT/EDIC collaborative study was provided by the National Institutes of Health through the National Institute of Diabetes and Digestive and Kidney Diseases grant number 5R01DK083927. Industry Contributions: Industry contributors have had no role in the DCCT/EDIC study but have provided free or discounted supplies or equipment to support participants’ adherence to the study: Abbott Diabetes Care (Alameda, CA), Animas (Westchester, PA), Bayer Diabetes Care (North America Headquarters, Tarrytown, NY), Becton Dickinson (Franklin Lakes, NJ), Eli Lilly (Indianapolis, IN), Extend Nutrition (St. Louis, MO), Insulet Corporation (Bedford, MA) , Lifescan (Milpitas, CA), Medtronic Diabetes (Minneapolis, MN), Nipro Home Diagnostics (Ft. Lauderdale, FL), Nova Diabetes Care (Billerica, MA), Omron (Shelton, CT), Perrigo Diabetes Care (Allegan, MI), Roche Diabetes Care (Indianapolis, IN) , and Sanofi-Aventis (Bridgewater, NJ).

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