title: Association of comorbidities with increasing severity of peripheral neuropathy in diabetes mellitus.
abstract: OBJECTIVE
  To analyze a large population of patients with diabetes and peripheral neuropathy (PN) to determine other meaningful comorbid etiologies for PN.
  
  
  METHODS
  Peripheral Neuropathy is a common complication of type 1 and 2 diabetes mellitus; however, other potential causes for PN may be co-existing in patients with diabetes. A prospective cohort study was performed to assess patients with diabetes and PN. We compared patients having PN due solely to diabetes with patients possessing co-existing comorbidities, performing clinical (Toronto Clinical Scoring System and the Utah Early Neuropathy Scale), laboratory and electrophysiological assessments in all patients.
  
  
  RESULTS
  Patients with either type 1 or 2 diabetes mellitus and co-existing comorbidities did not have more severe clinical or electrophysiological PN phenotypes overall. However, in patients with type 1 diabetes, presence of a lipid disorder was associated with greater PN severity. In type 2 diabetes patients, both a lipid disorder and cobalamin deficiency were associated with greater PN severity. There was no additive effect upon PN severity with presence of three or more comorbid etiologies.
  
  
  CONCLUSIONS
  The presence of specific, and not general, comorbidities in patients with type 1 or 2 diabetes corresponds with greater PN severity.
authors: Shafina Sachedina, School of Medicine, Royal College of Surgeons Ireland, Co. Dublin 2, Ireland.
authors: Shafina
authors: S
authors: Sachedina
authors: Cory
authors: C
authors: Toth
keywords: Cobalamin; Comorbidities; Diabetic peripheral neuropathy; Lipidemia; Methylmalonic acid
references: Arch Neurol. 2003 Sep;60(9):1296-301
references: 12975298
references: Diabetologia. 2008 Sep;51(9):1631-8
references: 18626626
references: Pharmacotherapy. 2004 Sep;24(9):1194-203
references: 15460180
references: Ann Neurol. 2003 Jul;54(1):19-29
references: 12838517
references: Diabetes Care. 2002 Nov;25(11):2048-52
references: 12401755
references: Clin Exp Optom. 2012 May;95(3):348-54
references: 22540156
references: Transplant Proc. 2005 Jun;37(5):2263-5
references: 15964394
references: J Peripher Nerv Syst. 2008 Sep;13(3):218-27
references: 18844788
references: Eur J Neurol. 2005 Oct;12(10):747-58
references: 16190912
references: Electroencephalogr Clin Neurophysiol. 1969 Jul;27(1):107
references: 4182876
references: Thyroid. 1995 Aug;5(4):283-6
references: 7488869
references: Neurology. 2001 Jun 26;56(12):1727-32
references: 11425941
references: Neurology. 1994 Nov;44(11):2185-6
references: 7969981
references: Eur Neurol. 2007;57(2):91-5
references: 17179711
references: J Neurol Neurosurg Psychiatry. 1997 Apr;62(4):310-8
references: 9120441
references: J Nutr. 2002 Sep;132(9):2799-803
references: 12221248
references: J Nurs Res. 2011 Mar;19(1):35-43
references: 21350385
references: Diabetologia. 2000 Aug;43(8):957-73
references: 10990072
references: Diabetes Care. 2010 Jan;33(1):156-61
references: 19846797
references: Muscle Nerve. 2000 Feb;23(2):150-2
references: 10639604
references: Neurology. 2002 May 14;58(9):1333-7
references: 12011277
references: N Engl J Med. 2005 Jan 27;352(4):341-50
references: 15673800
references: Neurology. 1976 Feb;26(2):152-61
references: 176611
references: Diabetes. 2009 Oct;58(10):2376-85
references: 19592619
references: PM R. 2009 Jan;1(1):5-13
references: 19627867
references: J Neurol. 2011 Aug;258(8):1431-6
references: 21331599
references: Neurol Clin. 2007 Feb;25(1):209-55
references: 17324726
references: J Peripher Nerv Syst. 2009 Dec;14(4):257-67
references: 20021567
references: Medicine (Baltimore). 1991 Jul;70(4):229-45
references: 1648656
references: Muscle Nerve. 1990 Feb;13(2):158-64
references: 2179719
references: Diabetes Care. 1996 May;19(5):509-13
references: 8732720
references: Muscle Nerve. 1997 Jan;20(1):59-64
references: 8995584
references: Diabetes Care. 2012 Jun;35(6):1333-40
references: 22511260