Summary: In a ground-breaking study, investigators found that decreased sensation in the foot may be an underrecognized risk factor for death. Mortality among adults with nondiabetic peripheral neuropathy was higher than mortality among adult diabetics without peripheral neuropathy.
Investigators from Johns Hopkins and the University of Mississippi Medical Center recently published, in the Annals of Internal Medicine, the results of a peer reviewed study on the relationship between peripheral neuropathy (PN) and mortality in U.S. adults.
In this prospective cohort study, the authors reviewed charts from the NHANES data base of 7116 adults aged 40 years or older who had standardized monofilament testing (5.07 Semmes-Weinstein/10-gram) for PN. During a median follow-up of 13 years 2128 participants died. The study found the incidence rates (per 1000 person-years) of all-cause mortality were:
- 58 in adults with PN and with diabetes
- 34 in adults with PN but without diabetes
- 27 in adults without PN but with diabetes
- 13 in adults without PN and without diabetes.
The authors concluded that PN was common–estimated to be 35 million adults based on the 2010 U.S. Census–and was independently associated with mortality in the U.S. population, even in the absence of diabetes. “The cumulative incidence of all-cause mortality among adults with PN but no diabetes was higher than that for adults with diabetes but no PN.”
Diabetes is the seventh leading cause of death in the US. The finding that adults with PN not caused by diabetes may have a higher mortality rate than adults with diabetes and without PN is quite surprising and certainly warrants further investigation. In light of this new information, clinicians may want to consider treating numbness in the feet aggressively with the use of nutrients, such as benfotiamine, which has been shown to improve peripheral nerve function in certain cases.