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Individuals with type 1 diabetes who exhibit signs of diabetic peripheral neuropathy (DPN) face a markedly higher risk of stroke. These findings were presented using data from the Finnish Diabetic Nephropathy (FinnDiane) Study at the European Association for the Study of Diabetes (EASD) 2025 conference.

The study consisted of 3,005 adults with type 1 diabetes, all free of stroke at baseline. DPN was assessed using the Michigan Neuropathy Screening Instrument Questionnaire (MNSI-Q). Scores ≥4 and ≥7 points were evaluated separately. Stroke events were tracked over a median follow-up of 9.8 years using national registries and medical records.

During follow-up, 123 participants (4.1%) experienced a stroke. Individuals who suffered a stroke had higher MNSI-Q scores, were older, and had a longer duration of diabetes. They also had a higher prevalence of kidney failure, cardiovascular disease, peripheral vascular disease, and proliferative diabetic retinopathy. After adjusting for traditional risk factors and other diabetic complications, DPN remained a strong independent predictor of stroke, with hazard ratios ranging from 1.82–5.05 depending on the MNSI-Q cutoff.

These findings indicate that screening for DPN using MNSI-Q could enhance risk stratification and guide preventive strategies for stroke in people with type 1 diabetes.
 

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Key highlights
  • Five distinct diabetes subtypes were identified based on glucose variability patterns from CGM data.
  • Each subtype demonstrated differential responses to targeted therapies, indicating potential for precision treatment.
  • GLP-1 receptor agonists, SGLT-2 inhibitors, and hybrid closed-loop insulin systems showed the greatest benefits in specific subgroups.
  • Classification based on individual glycemic behavior offers a framework for personalized diabetes management beyond traditional categories.
     
Source

 Itkonen S, Dahlström E, Eriksson M, et al. Peripheral diabetic neuropathy is associated with an increased risk of stroke, independently from other diabetic complications, in individuals with type 1 diabetes. Presented at: 61st EASD Annual Meeting of the European Association for the Study of Diabetes; September 15-19, 2025; Vienna, Austria. Diabetologia. 2025:98. https://link.springer.com/article/10.1007/s00125-025-06497-1#Sec17 

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Glucose Variability Patterns Reveal Five New Diabetes Subtypes for Personalized Therapy
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Continuous glucose monitoring uncovers distinct glycemic profiles, guiding targeted treatment strategies.
 

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