Comment on Jaiswal et al. Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study. Diabetes Care 2017;40:1226–1232

Abstract

We were interested by the recent article by Jaiswal et al. (1), who reported a high prevalence (22%) of diabetic peripheral neuropathy (DPN) in young subjects with type 2 diabetes in the SEARCH for Diabetes in Youth (SEARCH) study. Although significance was not reached for all the analyses in the type 2 diabetes group, long-term poor glycemic control, dyslipidemia, and smoking emerged as modifiable risk factors, and the authors suggested that their management may help to prevent or delay irreversible nerve damage. This optimistic view is, however, challenged by the results of multifactorial interventions: no improvement of vibration perception thresholds (VPT) in the Steno-2 study (2) and only a small initial improvement with later seemingly inexorable progression …