Sex differences in neuropathic pain in longstanding diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes

Nancy Cardinez; Leif E. Lovblom; Johnny Wei Bai; Evan Lewis; Alon Abraham; Daniel Scarr; Julie A. Lovshin; Yuliya Lytvyn; Genevieve Boulet; Mohammed A. Farooqi; Andrej Orszag; Alanna Weisman; Hillary A. Keenan; Michael H. Brent; Narinder Paul; Vera Bril; David Z. Cherney; Bruce A. Perkins

doi:10.1016/j.jdiacomp.2018.05.001

Sex differences in neuropathic pain in longstanding diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes

Nancy Cardinez, Leif E. Lovblom, Johnny Wei Bai, Evan Lewis, Alon Abraham, Daniel Scarr, Julie A. Lovshin, Yuliya Lytvyn, Genevieve Boulet, Mohammed A. Farooqi, Andrej Orszag, Alanna Weisman, Hillary A. Keenan, Michael H. Brent, Narinder Paul, Vera Bril, David Z. Cherney, Bruce A. Perkins^*

^*Corresponding author for this work

Neurology

Research output: Contribution to journal › Article › peer-review

26 Scopus citations

Abstract

Aim: Neuropathy and neuropathic pain are common complications of type 1 diabetes (T1D). We aimed to determine if sex-specific differences in neuropathic pain are present in adults with longstanding T1D. Methods: Canadians with ≥50 years of T1D (n = 361) completed health history questionnaires that included assessment of neuropathy (defined by Michigan Neuropathy Screening Instrument questionnaire components ≥3; NEUROPATHY_MNSI-Q) and neuropathic pain. Multivariable logistic regression was used to determine sex-differences in neuropathic pain controlling for neuropathy. Results: Participants had mean age 66 ± 9 years, median diabetes duration 53[51,58] years, mean HbA1c 7.5 ± 1.0%, and 207(57%) were female. Neuropathic pain was present in 128(36%) of all participants, more prevalent among those with NEUROPATHY_MNSI-Q compared to those without [96(63%) vs. 31(15%), p < 0.001], and more prevalent in females compared to males [87(42%) vs. 41(27%), p = 0.003]. Independent of the presence of NEUROPATHY_MNSI-Q and other factors, female sex was associated with the presence of neuropathic pain [OR 2.68 (95% CI 1.4–5.0), p = 0.002]. Conclusions: We demonstrated a novel sex-specific difference in neuropathic pain in females compared to males with longstanding T1D, independent of the presence of neuropathy. Further research using more objective measures of neuropathy than the MNSI is justified to further understand this sex-specific difference.

Original language	English
Pages (from-to)	660-664
Number of pages	5
Journal	Journal of Diabetes and its Complications
Volume	32
Issue number	7
DOIs	https://doi.org/10.1016/j.jdiacomp.2018.05.001
State	Published - Jul 2018

Funding

Funders	Funder number
Canadian Clinical Trial Network
Glaxo Smith Kline Canada
AstraZeneca
Johnson and Johnson
Merck
Roche
Sanofi
Medtronic
Boehringer Ingelheim
Juvenile Diabetes Research Foundation Canada	17-2013-312
Novo Nordisk

Keywords

Gender
Neuropathic pain
Neuropathy
Pain
Sex
Type 1 diabetes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jdiacomp.2018.05.001

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Cardinez, N., Lovblom, L. E., Bai, J. W., Lewis, E., Abraham, A., Scarr, D., Lovshin, J. A., Lytvyn, Y., Boulet, G., Farooqi, M. A., Orszag, A., Weisman, A., Keenan, H. A., Brent, M. H., Paul, N., Bril, V., Cherney, D. Z., & Perkins, B. A. (2018). Sex differences in neuropathic pain in longstanding diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes. Journal of Diabetes and its Complications, 32(7), 660-664. https://doi.org/10.1016/j.jdiacomp.2018.05.001

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title = "Sex differences in neuropathic pain in longstanding diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes",

abstract = "Aim: Neuropathy and neuropathic pain are common complications of type 1 diabetes (T1D). We aimed to determine if sex-specific differences in neuropathic pain are present in adults with longstanding T1D. Methods: Canadians with ≥50 years of T1D (n = 361) completed health history questionnaires that included assessment of neuropathy (defined by Michigan Neuropathy Screening Instrument questionnaire components ≥3; NEUROPATHYMNSI-Q) and neuropathic pain. Multivariable logistic regression was used to determine sex-differences in neuropathic pain controlling for neuropathy. Results: Participants had mean age 66 ± 9 years, median diabetes duration 53[51,58] years, mean HbA1c 7.5 ± 1.0%, and 207(57%) were female. Neuropathic pain was present in 128(36%) of all participants, more prevalent among those with NEUROPATHYMNSI-Q compared to those without [96(63%) vs. 31(15%), p < 0.001], and more prevalent in females compared to males [87(42%) vs. 41(27%), p = 0.003]. Independent of the presence of NEUROPATHYMNSI-Q and other factors, female sex was associated with the presence of neuropathic pain [OR 2.68 (95% CI 1.4–5.0), p = 0.002]. Conclusions: We demonstrated a novel sex-specific difference in neuropathic pain in females compared to males with longstanding T1D, independent of the presence of neuropathy. Further research using more objective measures of neuropathy than the MNSI is justified to further understand this sex-specific difference.",

keywords = "Gender, Neuropathic pain, Neuropathy, Pain, Sex, Type 1 diabetes",

author = "Nancy Cardinez and Lovblom, {Leif E.} and Bai, {Johnny Wei} and Evan Lewis and Alon Abraham and Daniel Scarr and Lovshin, {Julie A.} and Yuliya Lytvyn and Genevieve Boulet and Farooqi, {Mohammed A.} and Andrej Orszag and Alanna Weisman and Keenan, {Hillary A.} and Brent, {Michael H.} and Narinder Paul and Vera Bril and Cherney, {David Z.} and Perkins, {Bruce A.}",

note = "Publisher Copyright: {\textcopyright} 2018 Elsevier Inc.",

year = "2018",

month = jul,

doi = "10.1016/j.jdiacomp.2018.05.001",

language = "אנגלית",

volume = "32",

pages = "660--664",

journal = "Journal of Diabetes and its Complications",

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Cardinez, N, Lovblom, LE, Bai, JW, Lewis, E, Abraham, A, Scarr, D, Lovshin, JA, Lytvyn, Y, Boulet, G, Farooqi, MA, Orszag, A, Weisman, A, Keenan, HA, Brent, MH, Paul, N, Bril, V, Cherney, DZ & Perkins, BA 2018, 'Sex differences in neuropathic pain in longstanding diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes', Journal of Diabetes and its Complications, vol. 32, no. 7, pp. 660-664. https://doi.org/10.1016/j.jdiacomp.2018.05.001

TY - JOUR

T1 - Sex differences in neuropathic pain in longstanding diabetes

T2 - Results from the Canadian Study of Longevity in Type 1 Diabetes

AU - Cardinez, Nancy

AU - Lovblom, Leif E.

AU - Bai, Johnny Wei

AU - Lewis, Evan

AU - Abraham, Alon

AU - Scarr, Daniel

AU - Lovshin, Julie A.

AU - Lytvyn, Yuliya

AU - Boulet, Genevieve

AU - Farooqi, Mohammed A.

AU - Orszag, Andrej

AU - Weisman, Alanna

AU - Keenan, Hillary A.

AU - Brent, Michael H.

AU - Paul, Narinder

AU - Bril, Vera

AU - Cherney, David Z.

AU - Perkins, Bruce A.

PY - 2018/7

Y1 - 2018/7

N2 - Aim: Neuropathy and neuropathic pain are common complications of type 1 diabetes (T1D). We aimed to determine if sex-specific differences in neuropathic pain are present in adults with longstanding T1D. Methods: Canadians with ≥50 years of T1D (n = 361) completed health history questionnaires that included assessment of neuropathy (defined by Michigan Neuropathy Screening Instrument questionnaire components ≥3; NEUROPATHYMNSI-Q) and neuropathic pain. Multivariable logistic regression was used to determine sex-differences in neuropathic pain controlling for neuropathy. Results: Participants had mean age 66 ± 9 years, median diabetes duration 53[51,58] years, mean HbA1c 7.5 ± 1.0%, and 207(57%) were female. Neuropathic pain was present in 128(36%) of all participants, more prevalent among those with NEUROPATHYMNSI-Q compared to those without [96(63%) vs. 31(15%), p < 0.001], and more prevalent in females compared to males [87(42%) vs. 41(27%), p = 0.003]. Independent of the presence of NEUROPATHYMNSI-Q and other factors, female sex was associated with the presence of neuropathic pain [OR 2.68 (95% CI 1.4–5.0), p = 0.002]. Conclusions: We demonstrated a novel sex-specific difference in neuropathic pain in females compared to males with longstanding T1D, independent of the presence of neuropathy. Further research using more objective measures of neuropathy than the MNSI is justified to further understand this sex-specific difference.

AB - Aim: Neuropathy and neuropathic pain are common complications of type 1 diabetes (T1D). We aimed to determine if sex-specific differences in neuropathic pain are present in adults with longstanding T1D. Methods: Canadians with ≥50 years of T1D (n = 361) completed health history questionnaires that included assessment of neuropathy (defined by Michigan Neuropathy Screening Instrument questionnaire components ≥3; NEUROPATHYMNSI-Q) and neuropathic pain. Multivariable logistic regression was used to determine sex-differences in neuropathic pain controlling for neuropathy. Results: Participants had mean age 66 ± 9 years, median diabetes duration 53[51,58] years, mean HbA1c 7.5 ± 1.0%, and 207(57%) were female. Neuropathic pain was present in 128(36%) of all participants, more prevalent among those with NEUROPATHYMNSI-Q compared to those without [96(63%) vs. 31(15%), p < 0.001], and more prevalent in females compared to males [87(42%) vs. 41(27%), p = 0.003]. Independent of the presence of NEUROPATHYMNSI-Q and other factors, female sex was associated with the presence of neuropathic pain [OR 2.68 (95% CI 1.4–5.0), p = 0.002]. Conclusions: We demonstrated a novel sex-specific difference in neuropathic pain in females compared to males with longstanding T1D, independent of the presence of neuropathy. Further research using more objective measures of neuropathy than the MNSI is justified to further understand this sex-specific difference.

KW - Gender

KW - Neuropathic pain

KW - Neuropathy

KW - Pain

KW - Sex

KW - Type 1 diabetes

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Sex differences in neuropathic pain in longstanding diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes

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UN SDGs

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