Diabetic Family History is Associated with Severity of Peripheral Neuropathy

Background Clinicians lack tools to determine a patient’s risk for diabetic peripheral neuropathy (DPN). This study examined the relationship between severity of DPN and family history of diabetes and DPN. Methods The Michigan Neuropathy Screening Instrument (MNSI) was used to collect symptom and physical exam data from consenting diabetic and control (n=293) patients. Family history of diabetes, DPN and major complications were collected going back two generations. Relevant additional characteristics were mined from patient medical records. Results Between patients who did and did not meet MNSI criteria for neuropathy, there were significant differences in comorbidities, including cardiac ( P <.0001), renal (P =.006), PVD (P<.0001), and thyroid (P =.027). Patients with history of diabetes on both sides (P=.032) or siblings (P<.0001); history of neuropathy on their maternal (P=.026), paternal (P=.002), both sides (P=.002) or siblings (P=.002); history of amputations on their maternal (P=.039) or paternal side (P=.162); or a history of ulcers on their maternal side (P=.030), paternal side (P=.005) or both sides (P=.046) were more likely to meet MNSI criteria for neuropathy. MNSI criteria for neuropathy was independently associated with history of cardiac or PVD comorbidities, and an MNSI score in the upper quartile was associated with diabetic siblings (OR=10.96). Conclusion: Family history of diabetes, DPN, and major complications was associated with neuropathy and also stronger degree of neuropathy. Family history, specifically diabetic siblings, cardiac and PVD comorbidities are independent risk factors for developing DPN. Clinicians should gather detailed family history and relevant comorbidities to optimize prevention of severe DPN in diabetics. Keywords:Type 2; Diabetic peripheral neuropathy; Family history of diabetes; MNSI; Complications