Improving prediction and detection of diabetic peripheral neuropathy in primary care – a base for personalized care.

The present purpose is to gain insight into the development of a serious and incurable complication of diabetes, diabetic peripheral neuropathy (DPN), in order to be able to predict its development. Type 2 diabetes (T2D) is globally a common disease, affecting about 400,000 of the adult population in Sweden.

Most people with T2D are treated in primary care.

The most frequent complication in T2D is peripheral neuropathy; 50% will develop DPN after ten years of disease duration resulting in low quality of life and shortened lifetime.

We intend to perform a 20-year follow-up of a unique population-based cohort from the primary care, consisting of people who initially were 60-years of age, normoglycemic, or had T2D in 2004 (n=119/T2D=51) and who were followed up in 2014 (n=87/T2D=42). Today, 89/119 are still alive and can be invited.

They will have a follow-up time of 20-years, examined according to a standardized protocol with valid methods. Furthermore, we will have access to new and stored blood samples collected at three-time points.

In addition to clinical routine examinations, and an electrophysiological examination to assess nerve function, we will use single-cell sequencing, which is the latest technique, as well as proteomics and metabolomics to explore new risk markers.

Taken together, our aim is to improve the prediction and early diagnosis of DPN, which will facilitate personalized care of people with DPN in the primary care setting.