TY - JOUR
T1 - Prevalence of diabetic peripheral neuropathy and relation to glycemic control therapies at baseline in the BARI 2D cohort
AU - Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Investigators
AU - Pop-Busui, Rodica
AU - Lu, Jiang
AU - Lopes, Neuza
AU - Jones, Teresa L.Z.
AU - Detre, Katherine M.
AU - Kelsey, Sheryl F.
AU - Brooks, Maria Mori
AU - Kelley, David
AU - Orchard, Trevor J.
AU - Rana, Jamal
AU - Thomas, Stephen B.
AU - Tyrrell, Kim Sutton
AU - Holubkov, Richard
AU - Averbach, Frani
AU - Crow, Sharon W.
AU - Macgregor, Joan M.
AU - O’Neal, Scott M.
AU - Pitluga, Kathleen
AU - Sansing, Veronica
AU - Tranchine, Mary
AU - Hardison, Regina
AU - Kip, Kevin
AU - Lombardero, Manuel
AU - Janiszewski, Sue
AU - Protivnak, Darina
AU - Reiser, Sarah
AU - Barton, Stephen
AU - Kushner, Yulia
AU - Michael, Owen
AU - Martin, Jeffrey P.
AU - Kania, Christopher
AU - Kania, Michael
AU - O’Donnell, Jeffrey
AU - Maxwell, Rae Ann
AU - Frye, Robert L.
AU - Goldberg, Suzanne
AU - Rosenberg, Yves
AU - Desvigne-Nickens, Patrice
AU - Ershow, Abby
AU - Gordon, David
AU - Paltoo, Dina
AU - Hueb, Whady
AU - Ramires, José
AU - Wajchenberg, Bernardo
AU - Martinez, Eulogio E.
AU - Oliveira, Sergio A.
AU - Betti, Roberto
AU - Schwartz, Leonard
AU - Steiner, George
AU - Kleiman, Neal
PY - 2009/3
Y1 - 2009/3
N2 - We evaluated the associations between glycemic therapies and prevalence of diabetic peripheral neuropathy (DPN) at baseline among participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial on medical and revascularization therapies for coronary artery disease (CAD) and on insulin-sensitizing vs. insulin-providing treatments for diabetes. A total of 2,368 patients with type 2 diabetes and CAD was evaluated. DPN was defined as clinical examination score >2 using the Michigan Neuropathy Screening Instrument (MNSI). DPN odds ratios across different groups of glycemic therapy were evaluated by multiple logistic regression adjusted for multiple covariates including age, sex, hemoglobin A1c (HbA1c), and diabetes duration. Fifty-one percent of BARI 2D subjects with valid baseline characteristics and MNSI scores had DPN. After adjusting for all variables, use of insulin was significantly associated with DPN (OR = 1.57, 95% CI: 1.15-2.13). Patients on sulfonylurea (SU) or combination of SU/metformin (Met)/thiazolidinediones (TZD) had marginally higher rates of DPN than the Met/TZD group. This cross-sectional study in a cohort of patients with type 2 diabetes and CAD showed association of insulin use with higher DPN prevalence, independent of disease duration, glycemic control, and other characteristics. The causality between a glycemic control strategy and DPN cannot be evaluated in this cross-sectional study, but continued assessment of DPN and randomized therapies in BARI 2D trial may provide further explanations on the development of DPN.
AB - We evaluated the associations between glycemic therapies and prevalence of diabetic peripheral neuropathy (DPN) at baseline among participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial on medical and revascularization therapies for coronary artery disease (CAD) and on insulin-sensitizing vs. insulin-providing treatments for diabetes. A total of 2,368 patients with type 2 diabetes and CAD was evaluated. DPN was defined as clinical examination score >2 using the Michigan Neuropathy Screening Instrument (MNSI). DPN odds ratios across different groups of glycemic therapy were evaluated by multiple logistic regression adjusted for multiple covariates including age, sex, hemoglobin A1c (HbA1c), and diabetes duration. Fifty-one percent of BARI 2D subjects with valid baseline characteristics and MNSI scores had DPN. After adjusting for all variables, use of insulin was significantly associated with DPN (OR = 1.57, 95% CI: 1.15-2.13). Patients on sulfonylurea (SU) or combination of SU/metformin (Met)/thiazolidinediones (TZD) had marginally higher rates of DPN than the Met/TZD group. This cross-sectional study in a cohort of patients with type 2 diabetes and CAD showed association of insulin use with higher DPN prevalence, independent of disease duration, glycemic control, and other characteristics. The causality between a glycemic control strategy and DPN cannot be evaluated in this cross-sectional study, but continued assessment of DPN and randomized therapies in BARI 2D trial may provide further explanations on the development of DPN.
KW - Coronary artery disease
KW - Diabetic peripheral neuropathy
KW - Glycemic control therapy
KW - Michigan Neuropathy Screening Instrument
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=62849093932&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=62849093932&partnerID=8YFLogxK
U2 - 10.1111/j.1529-8027.2009.00200.x
DO - 10.1111/j.1529-8027.2009.00200.x
M3 - Article
C2 - 19335534
AN - SCOPUS:62849093932
VL - 14
SP - 1
EP - 13
JO - Journal of the Peripheral Nervous System
JF - Journal of the Peripheral Nervous System
SN - 1085-9489
IS - 1
ER -