{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T19:58:12Z","timestamp":1762027092497,"version":"build-2065373602"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,4]],"date-time":"2020-12-04T00:00:00Z","timestamp":1607040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000901","name":"Juvenile Diabetes Research Foundation International","doi-asserted-by":"publisher","award":["27\u20102008\u2010362"],"award-info":[{"award-number":["27\u20102008\u2010362"]}],"id":[{"id":"10.13039\/100000901","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Peripheral Nervous Sys"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A proportion of individuals with type 1 diabetes mellitus for more than 50\u2009years (medallists) may be protected from developing nephropathy, retinopathy and neuropathy. Detailed neuropathy phenotyping was undertaken in a cohort of 33 medallists aged 63.7\u2009\u00b1\u20091.4\u2009years with diabetes for 58.5\u2009\u00b1\u20090.8\u2009years and HbA1c of 65.9\u2009\u00b1\u20092.1\u2009mmol\/mmol. Medallists had a significantly higher HbA1c (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), lower estimated glomerular filtration rate (eGFR) (<jats:italic>P<\/jats:italic> = .005) and higher albumin creatinine excretion ratio (ACR) (<jats:italic>P<\/jats:italic> = .01), but a lower total cholesterol (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), triacylglycerols (<jats:italic>P<\/jats:italic> = .001), low density lipoprotein\u2010cholesterol (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and higher high density lipoprotein\u2010cholesterol (<jats:italic>P<\/jats:italic> = .03), compared to controls. Twenty\u2010four percent of participants were identified as \u201cescapers\u201d without confirmed diabetic neuropathy. They had a lower neuropathy symptom profile (<jats:italic>P<\/jats:italic> = .002), vibration perception threshold (<jats:italic>P<\/jats:italic> = .02), warm threshold (<jats:italic>P<\/jats:italic> = .05), higher peroneal amplitude (<jats:italic>P<\/jats:italic> = .005), nerve conduction velocity (<jats:italic>P<\/jats:italic> = .03), heart rate variability (<jats:italic>P<\/jats:italic> = .001), corneal nerve fibre density (<jats:italic>P<\/jats:italic> = 0.001), branch density (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and length (<jats:italic>P<\/jats:italic> = .001), compared to medallists with diabetic neuropathy. Escapers had a shorter duration of diabetes (<jats:italic>P<\/jats:italic> = .006), lower alcohol consumption (<jats:italic>P<\/jats:italic> = .04), lower total cholesterol (<jats:italic>P<\/jats:italic> = .04) and LDL (<jats:italic>P<\/jats:italic> = .02), higher eGFR (<jats:italic>P<\/jats:italic> = .001) and lower ACR (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Patients with extreme duration diabetes without diabetic neuropathy have a comparable HbA1c, blood pressure and body mass index, but a more favourable lipid profile and consume less alcohol compared to those with diabetic neuropathy.<\/jats:p>","DOI":"10.1111\/jns.12423","type":"journal-article","created":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T07:13:59Z","timestamp":1606288439000},"page":"49-54","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Protection from neuropathy in extreme duration type 1 diabetes"],"prefix":"10.1111","volume":"26","author":[{"given":"Shazli","family":"Azmi","sequence":"first","affiliation":[{"name":"Faculty of Biology, Medicine and Health University of Manchester and Manchester University Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Ferdousi","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health University of Manchester and Manchester University Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alise","family":"Kalteniece","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health University of Manchester and Manchester University Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis N.","family":"Petropoulos","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medicine\u2010Qatar  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Ponirakis","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medicine\u2010Qatar  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uazman","family":"Alam","sequence":"additional","affiliation":[{"name":"Diabetes &amp; Endocrinology Research Institute of Cardiovascular and Metabolic Medicine and The Pain Research Institute, University of Liverpool and Liverpool University NHS Hospital Trust  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Asghar","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health University of Manchester and Manchester University Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Marshall","sequence":"additional","affiliation":[{"name":"Institute of Life course and Medical Sciences University of Liverpool  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adhithya","family":"Sankar","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health University of Manchester and Manchester University Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J. M.","family":"Boulton","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health University of Manchester and Manchester University Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Handrean","family":"Soran","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health University of Manchester and Manchester University Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Efron","sequence":"additional","affiliation":[{"name":"Institute of Health and Biomedical Innovation Queensland University of Technology  Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7188-8903","authenticated-orcid":false,"given":"Rayaz A.","family":"Malik","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health University of Manchester and Manchester University Foundation Trust  Manchester UK"},{"name":"Department of Medicine Weill Cornell Medicine\u2010Qatar  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1987.tb00863.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-009-1275-1"},{"issue":"169","key":"e_1_2_8_4_1","first-page":"145","article-title":"Long\u2010term diabetes. 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