{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T13:53:41Z","timestamp":1781013221844,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":313,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic neuropathy (DN) and nephropathy (DKD) are prevalent microvascular complications in Type 2 diabetes mellitus (T2DM), often evolving silently. Detecting early nephropathy remains a clinical challenge, especially in patients with preserved renal function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective was to determine whether the Toronto Clinical Scoring System (TCS) for diabetic neuropathy can predict early nephropathy (albuminuria) in people with well\u2010controlled T2DM who have a normal eGFR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a cross\u2010sectional study with 122 T2DM patients (HbA1c &lt; 7\n                      <jats:italic>%<\/jats:italic>\n                      , eGFR &gt; 90) to look for peripheral neuropathy using TCS and nephropathy using the urinary albumin\u2010to\u2010creatinine ratio (UACR). Patients were classified based on the presence of albuminuria (UACR \u2265 30\u2009mg\/g). Statistical analyses included\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, chi\u2010square tests, Spearman correlation, and logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with diabetic nephropathy or neuropathy were significantly older and exhibited higher systolic blood pressure and albuminuria. A clear stepwise increase in albuminuria was observed with rising neuropathy severity, with nephropathy prevalence ranging from 42% in patients without neuropathy to 72% in those with severe neuropathy. A significant positive correlation between TCS and UACR (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = 0.29,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0012) supports a progressive link between nerve and kidney involvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinical diabetic neuropathy is significantly associated with early nephropathy in well\u2010controlled T2DM patients. Routine neuropathy assessment may serve as a simple, cost\u2010effective predictor of subclinical renal damage. Future prospective studies should investigate whether early intervention in patients with neuropathy can attenuate or delay renal injury and whether this predictive link holds true across diverse ethnic and age groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jdr\/3736035","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T05:44:47Z","timestamp":1762839887000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early Neuropathy as a Predictor of Subclinical Diabetic Nephropathy in Well\u2010Controlled Type 2 Diabetic Patients: A Cross\u2010Sectional Study"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4773-7379","authenticated-orcid":false,"given":"Sherif Mohamed","family":"Zaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"El Karsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghosoun Anas","family":"Moallem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman Hatem Adel","family":"Sembawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moayad Saeed Omar","family":"Alsubhani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz Mahmoud Wahbi","family":"Sindi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Khalid Omar","family":"Alafif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal Waleed Abdullah","family":"Mulla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.3390\/biom14121486"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_1237_21"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-018-0519-9"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.5144\/0256-4947.2018.03.01.1010"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.33176"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0106935"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0088956"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.suppl_1.S4"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.06.019"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2023.101726"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2042"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/life13020539"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.56674"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1377923"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.10-5-505"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2009.02667.x"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S335283"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.5527\/wjn.v3.i1.6"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1359255"},{"key":"e_1_2_9_20_2","first-page":"2123","article-title":"Evaluation and Prevention of Diabetic Neuropathy","volume":"71","author":"Aring A. 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