Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans

Caroline A. Abbott, Nishi Chaturvedi, Rayaz Malik, Eleanna Salgami, Allen P. Yates, Philip W. Pemberton, Andrew J.M. Boulton

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1325-1330
Number of pages6
JournalDiabetes Care
Volume33
Issue number6
DOIs
Publication statusPublished - Jun 2010
Externally publishedYes

Fingerprint

Diabetic Neuropathies
Neural Conduction
Signs and Symptoms
Blood Vessels
Foot Ulcer
Diabetes Complications
Amputation
Type 2 Diabetes Mellitus
Foot
Research Design
Cardiovascular Diseases
Cross-Sectional Studies
Smoking
Odds Ratio
Oxygen
Skin

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

Abbott, C. A., Chaturvedi, N., Malik, R., Salgami, E., Yates, A. P., Pemberton, P. W., & Boulton, A. J. M. (2010). Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans. Diabetes Care, 33(6), 1325-1330. https://doi.org/10.2337/dc09-2067

Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans. / Abbott, Caroline A.; Chaturvedi, Nishi; Malik, Rayaz; Salgami, Eleanna; Yates, Allen P.; Pemberton, Philip W.; Boulton, Andrew J.M.

In: Diabetes Care, Vol. 33, No. 6, 06.2010, p. 1325-1330.

Research output: Contribution to journalArticle

Abbott, CA, Chaturvedi, N, Malik, R, Salgami, E, Yates, AP, Pemberton, PW & Boulton, AJM 2010, 'Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans', Diabetes Care, vol. 33, no. 6, pp. 1325-1330. https://doi.org/10.2337/dc09-2067
Abbott CA, Chaturvedi N, Malik R, Salgami E, Yates AP, Pemberton PW et al. Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans. Diabetes Care. 2010 Jun;33(6):1325-1330. https://doi.org/10.2337/dc09-2067
Abbott, Caroline A. ; Chaturvedi, Nishi ; Malik, Rayaz ; Salgami, Eleanna ; Yates, Allen P. ; Pemberton, Philip W. ; Boulton, Andrew J.M. / Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans. In: Diabetes Care. 2010 ; Vol. 33, No. 6. pp. 1325-1330.
@article{7be2f11068d646849d43b4cb37024a39,
title = "Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans",
abstract = "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.",
author = "Abbott, {Caroline A.} and Nishi Chaturvedi and Rayaz Malik and Eleanna Salgami and Yates, {Allen P.} and Pemberton, {Philip W.} and Boulton, {Andrew J.M.}",
year = "2010",
month = "6",
doi = "10.2337/dc09-2067",
language = "English",
volume = "33",
pages = "1325--1330",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "6",

}

TY - JOUR

T1 - Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans

AU - Abbott, Caroline A.

AU - Chaturvedi, Nishi

AU - Malik, Rayaz

AU - Salgami, Eleanna

AU - Yates, Allen P.

AU - Pemberton, Philip W.

AU - Boulton, Andrew J.M.

PY - 2010/6

Y1 - 2010/6

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=77956065776&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956065776&partnerID=8YFLogxK

U2 - 10.2337/dc09-2067

DO - 10.2337/dc09-2067

M3 - Article

C2 - 20215455

AN - SCOPUS:77956065776

VL - 33

SP - 1325

EP - 1330

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 6

ER -