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Original research
Chronic inflammatory demyelinating polyneuropathy associated with diabetes: a European multicentre comparative reappraisal
  1. Yusuf A Rajabally1,2,
  2. Stojan Peric3,
  3. Mina Cobeljic3,
  4. Saadia Afzal1,
  5. Ivo Bozovic3,
  6. Aleksa Palibrk3,
  7. Ivana Basta3
  1. 1 Inflammatory Neuropathy Clinic, University Hospitals of Birmingham, Birmingham, UK
  2. 2 Aston Medical School, Aston University, Birmingham, United Kingdom
  3. 3 Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
  1. Correspondence to Prof. Yusuf A Rajabally, Inflammatory Neuropathy Clinic, University Hospitals of Birmingham, Birmingham B4 7ET, UK; y.rajabally{at}aston.ac.uk

Abstract

Introduction The association between chronic inflammatory demyelinating polyneuropathy (CIDP) and diabetes is uncertain despite important diagnostic and management implications.

Methods We retrospectively analysed two European cohorts, totaling 257 patients with ‘definite’ or ‘probable’ CIDP, from Serbia and Birmingham, UK.

Results Diabetes was present at CIDP diagnosis in 25/139 (18%) subjects in the Serbian cohort and in 23/118 (19.5%) in the UK cohort. In both cohorts, diabetes prevalence was higher than local general population prevalence rates (RR: 2.09; 95% CI 1.39 to 2.95 and RR: 2.22; 95% CI 1.46 to 3.17, respectively). Considering typical CIDP only, diabetes prevalence was greater than expected in both cohorts (RR: 2.58; 95% CI 1.60 to 3.82 and RR: 2.68; 95% CI 1.71 to 3.87, respectively). CIDP with diabetes occurred later in life than CIDP without diabetes (58.96 years, SD: 11.09 vs 51.71 years, SD: 16.02; p=0.003) and presented more frequently in the typical form than in patients without diabetes (79.2% vs 61.2%; p=0.02). Baseline Inflammatory Neuropathy Cause and Treatment disability scores were similar in patients with and without diabetes (p=0.90). Proportions of treatment responders were similar in both groups (70% vs 74.9%; p=0.65), as were response amplitudes (p=0.87).

Discussion Our results, both for all CIDP and typical CIDP presentations, support a twofold increased relative risk of diabetes compared with the general population. CIDP with diabetes appears to present older and more frequently in the typical form, as compared with CIDP without diabetes. CIDP with diabetes appears similar to CIDP without diabetes in disability levels at diagnosis and probability, as well as amplitude of treatment response.

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Footnotes

  • Contributors YAR, SP and IBa: study conception, data collection, design, analysis and writing of the first draft. MC, SA, IBo and AP: data collection, analysis and review of the first draft for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests YAR has received speaker/consultancy honoraria from CSL Behring, LFB, Grifols, BPL, Octapharma and Kedrion, has received educational sponsorships from LFB, CSL Behring and Baxter and has obtained research grants from CSL Behring and LFB. SP has received consultancy honoraria from Argenx, Pfizer, Mylan, Salveo and ADOC, speaker honoraria from Pfizer, Actavis, Berlin Chemie Menarini, Mylan, Krka, Wowag Pharma and ADOC and has obtained research grants from Kedrion and Octapharma. IBa has received speaker honoraria from Pfizer, Actavis, Berlin Chemie Menarini, Mylan, Krka and ADOC and has obtained research grants from Kedrion and Octapharma.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved and registered by our both respective relevant institutional boards. This was by the Ethical Board of the Neurology Clinic, Clinical Centre of Serbia and the University Hospitals of Birmingham Clinical Audit Office (CARMS no. 15747, December 2019).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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