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Explanations for the Lower Rates of Diabetic Neuropathy in Indian Asians Versus Europeans

Diabetes care, 2010-06, Vol.33 (6), p.1325-1330 [Peer Reviewed Journal]

2015 INIST-CNRS ;COPYRIGHT 2010 American Diabetes Association ;Copyright American Diabetes Association Jun 2010 ;2010 by the American Diabetes Association. ;ISSN: 0149-5992 ;EISSN: 1935-5548 ;DOI: 10.2337/dc09-2067 ;PMID: 20215455 ;CODEN: DICAD2

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Title:
Explanations for the Lower Rates of Diabetic Neuropathy in Indian Asians Versus Europeans
Author: Abbott, Caroline A ; Chaturvedi, Nishi ; Malik, Rayaz A ; Salgami, Eleanna ; Yates, Allen P ; Pemberton, Philip W ; Boulton, Andrew J.M
Subjects: Aged ; Asian Continental Ancestry Group ; Asians ; Biological and medical sciences ; Cardiovascular diseases ; Case-Control Studies ; Cross-Sectional Studies ; Diabetes ; Diabetes. Impaired glucose tolerance ; Diabetic neuropathies ; Diabetic Neuropathies - epidemiology ; Diabetic Neuropathies - ethnology ; Diabetic neuropathy ; Diabetics ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Ethnicity ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; European Continental Ancestry Group ; Europeans ; Family medical history ; Female ; Foot diseases ; Health care access ; Heart attacks ; Humans ; India ; Male ; Medical research ; Medical sciences ; Medicine, Experimental ; Metabolic diseases ; Microvessels ; Middle Aged ; Miscellaneous ; Mortality ; Original Research ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Risk Factors ; Skin - blood supply ; Terminal illnesses ; Triglycerides ; Type 2 diabetes ; United Kingdom - epidemiology ; Wound healing
Is Part Of: Diabetes care, 2010-06, Vol.33 (6), p.1325-1330
Description: OBJECTIVE: Risks of diabetes and cardiovascular disease are elevated worldwide in Indian Asians. However, risks of other diabetes-related complications, i.e., foot ulceration and amputation, also with a vascular basis, are substantially lower in Asians than in white Europeans in the U.K., possibly due to less neuropathy. We therefore compared signs, symptoms, and objective quantitative measures of diabetic neuropathy and their risk factors in Indian Asians and Europeans. RESEARCH DESIGN AND METHODS: This was a cross-sectional study of a population-based sample of age- and sex-matched adults with type 2 diabetes of European (95 male and 85 female) and Asian (96 male and 84 female) descent in the U.K. Patients were assessed for neuropathic symptoms, signs, nerve conduction, autonomic function, and quantitative sensory testing. Peripheral vascular function and other potential risk factors for neuropathy were measured. RESULTS: Mean nerve conduction velocity Z scores were better in Asians (mean ± SD 0.07 ± 0.62) than in Europeans (-0.11 ± 0.60; P = 0.007) and were explained by the shorter height, fewer pack-years smoked, and higher transcutaneous oxygen levels (TCpO₂) in Indian Asians (P value for ethnic comparison attenuated to 0.2). Small fiber neuropathy was less prevalent in Indian Asians compared with Europeans (odds ratio 0.58 [95% CI 0.37-0.93]; P = 0.02) and was primarily accounted for by better TCpO₂ (0.70 [0.40-1.21]; P = 0.2). CONCLUSIONS: Asians with diabetes have substantially less large and small fiber neuropathy than Europeans, despite comparable traditional risk factors. Independent from smoking, the lower risk of neuropathy in Asians is due to better skin microvascularization and may help explain the substantially reduced Asian foot ulcer risk.
Publisher: Alexandria, VA: American Diabetes Association
Language: English
Identifier: ISSN: 0149-5992
EISSN: 1935-5548
DOI: 10.2337/dc09-2067
PMID: 20215455
CODEN: DICAD2
Source: GFMER Free Medical Journals
MEDLINE
Alma/SFX Local Collection
ProQuest Central

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Explanations for the Lower Rates of Diabetic Neuropathy in Indian Asians Versus Europeans

2015 INIST-CNRS ;COPYRIGHT 2010 American Diabetes Association ;Copyright American Diabetes Association Jun 2010 ;2010 by the American Diabetes Association. ;ISSN: 0149-5992 ;EISSN: 1935-5548 ;DOI: 10.2337/dc09-2067 ;PMID: 20215455 ;CODEN: DICAD2

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