Diabetic peripheral neuropathy (DPN) and diabetic nephropathy (DN) share common pathological mechanisms and are favorably impacted by intensive glycemic control. American Indians have disproportionately higher rates of type 2 diabetes (T2D), younger age of diabetes onset, and earlier development of long-term complications than other ethnic groups (1). Diabetes as an underlying cause of death is 2.5–3.5 times higher among American Indians than whites, yet the DPN burden among American Indians has not been systematically evaluated. We assessed DPN prevalence in Pima Indians and evaluated the relationship between DPN and DN.

A total of 79 Pima Indians with T2D (age 53 6 11 years, diabetes duration 25 6 6 years, 73% female, and mean HbA1c 9.5 6 1.9%[80 6 7 mmol/mol]) from the Gila River community were enrolled. DPN status was ascertained using the Michigan Neuropathy Screening Instrument (MNSI)(2) and defined by an MNSI exam (MNSIE) score $2.5. Renal function was assessed by estimated glomerular filtration rate (eGFR), the urinary clearance of iothalamate (measured GFR), and albumin-to-creatinine ratio (ACR).