Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes
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.
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.
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.
KeywordsPeripheral neuropathy Lower extremity disease Type 1 diabetes Type 2 diabetes Microvascular complications
We thank Dr. Andrew Boulton for his review of and insights regarding this manuscript.
Dr. Selvin was supported by grants K24 DK106414 and R01 DK089174 from the National Institutes of Health (NIDDK) related to this topic.
Compliance with Ethical Standards
Conflict of Interest
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.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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