{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:51:44Z","timestamp":1792047104451,"version":"4.4.0"},"reference-count":38,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T00:00:00Z","timestamp":1587340800000},"content-version":"vor","delay-in-days":68,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:p>The Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications (DCCT\/EDIC) study demonstrated that intensive glucose control reduced the risk of developing diabetic peripheral neuropathy (DPN) and cardiovascular autonomic neuropathy (CAN). We evaluated multiple risk factors and phenotypes associated with DPN and CAN in this large, well-characterized cohort of participants with type 1 diabetes, followed for &amp;gt;23 years. DPN was defined by symptoms, signs, and nerve conduction study abnormalities in \u22652 nerves; CAN was assessed using standardized cardiovascular reflex tests. Generalized estimating equation models assessed the association of DPN and CAN with individual risk factors measured repeatedly. During DCCT\/EDIC, 33% of participants developed DPN and 44% CAN. Higher mean HbA1c was the most significant risk factor for DPN, followed by older age, longer duration, greater height, macroalbuminuria, higher mean pulse rate, \u03b2-blocker use, and sustained albuminuria. The most significant risk factor for CAN was older age, followed by higher mean HbA1c, sustained albuminuria, longer duration of type 1 diabetes, higher mean pulse rate, higher mean systolic blood pressure, \u03b2-blocker use, estimated glomerular filtration rate &amp;lt;60 mL\/min\/1.73 m2, higher most recent pulse rate, and cigarette smoking. These findings identify risk factors and phenotypes of participants with diabetic neuropathy that can be used in the design of new interventional trials and for personalized approaches to neuropathy prevention.<\/jats:p>","DOI":"10.2337\/db19-1046","type":"journal-article","created":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T03:49:17Z","timestamp":1581565757000},"page":"1000-1010","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":207,"title":["Risk Factors for Diabetic Peripheral Neuropathy and Cardiovascular Autonomic Neuropathy in the Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications (DCCT\/EDIC) Study"],"prefix":"10.2337","volume":"69","clinical-trial-number":[{"clinical-trial-number":"nct00360815","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct00360893","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2184-9754","authenticated-orcid":false,"given":"Barbara H.","family":"Braffett","sequence":"first","affiliation":[{"name":"Biostatistics Center, George Washington University, Rockville, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7376-6870","authenticated-orcid":false,"given":"Rose A.","family":"Gubitosi-Klug","sequence":"additional","affiliation":[{"name":"Rainbow Babies & Children\u2019s Hospital, Case Western Reserve University, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W.","family":"Albers","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva L.","family":"Feldman","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine L.","family":"Martin","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil H.","family":"White","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine in St. Louis, St Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor J.","family":"Orchard","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5572-1700","authenticated-orcid":false,"given":"Maria","family":"Lopes-Virella","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9838-2841","authenticated-orcid":false,"given":"John M.","family":"Lachin","sequence":"additional","affiliation":[{"name":"Biostatistics Center, George Washington University, Rockville, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2042-1350","authenticated-orcid":false,"given":"Rodica","family":"Pop-Busui","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the DCCT\/EDIC Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2020,2,12]]},"reference":[{"key":"2022031303075035900_B1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.2337\/dc16-2042","article-title":"Diabetic neuropathy: a position statement by the American Diabetes Association","volume":"40","author":"Pop-Busui","year":"2017","journal-title":"Diabetes Care"},{"key":"2022031303075035900_B2","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.jdiacomp.2014.10.013","article-title":"Healthcare utilization and costs in diabetes relative to the clinical spectrum of painful diabetic peripheral neuropathy","volume":"29","author":"Sadosky","year":"2015","journal-title":"J Diabetes Complications"},{"key":"2022031303075035900_B3","doi-asserted-by":"crossref","first-page":"2886","DOI":"10.1161\/CIRCULATIONAHA.108.837369","article-title":"Effects of prior intensive insulin therapy on cardiac autonomic nervous system function in type 1 diabetes mellitus: the Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications study (DCCT\/EDIC)","volume":"119","author":"Pop-Busui","year":"2009","journal-title":"Circulation"},{"key":"2022031303075035900_B4","doi-asserted-by":"crossref","first-page":"741","DOI":"10.2337\/diacare.13.7.741","article-title":"Factors associated with avoidance of severe complications after 25 yr of IDDM. 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