TOPLINE:

Diabetic peripheral neuropathy (DPN), defined as a vibration perception threshold (VPT) above 25 V, was significantly associated with an increased risk for dementia and cerebrovascular disease in patients with type 2 diabetes (T2D).

METHODOLOGY:

• Researchers evaluated the association between DPN and the risk for all-cause dementia and cerebrovascular disease in patients with type 1 diabetes (T1D) and T2D.
• They included 5641 patients with T1D (mean age, 40.5 years; 45.3% women) and 9395 patients with T2D (mean age, 59.9 years; 38.6% women) who underwent longitudinal VPT measurements during annual diabetes follow-up visits.
• DPN was defined using two established definitions: a bilateral VPT above 25 V (fixed cutoff) and a bilateral VPT above an age-, sex-, and height-adjusted threshold (adjusted cutoff).
• Outcomes included all-cause dementia and cerebrovascular disease identified using standardised codes.

TAKEAWAY:

• In patients with T1D, DPN — defined using a fixed cutoff — was associated with an increased risk for cerebrovascular disease (incidence rate ratio [IRR], 1.45; 95% CI, 1.11-1.91) but not dementia. This association attenuated after adjustment for microvascular complications.
• In patients with T2D, DPN — defined using a fixed cutoff — was associated with an increased risk for both dementia (IRR, 4.36; 95% CI, 2.07-9.16) and cerebrovascular disease (IRR, 1.45; 95% CI, 1.18-1.80). After adjusting for microvascular complications, both the associations remained significant.
• Using the adjusted cutoff, DPN was associated with an increased risk for cerebrovascular disease (IRR, 1.74; 95% CI, 1.21-2.52) but not dementia in patients with T1D. In contrast, for those with T2D, DPN was linked to an increased risk for dementia (IRR, 2.97; 95% CI, 1.53-5.75), but not cerebrovascular disease.
• After adjusting for microvascular complications, DPN remained associated with an increased risk for dementia in patients with T2D (IRR, 3.61; 95% CI, 1.65-7.89).

IN PRACTICE:

"[The study] findings suggest that DPN may serve as a marker of increased risk of dementia and cerebrovascular disease," the authors wrote.

SOURCE:

This study was led by Astrid Wiggers, Steno Diabetes Center Copenhagen, Copenhagen, Denmark. It was published online on May 10, 2026, in Diabetes, Obesity and Metabolism.

LIMITATIONS:

The T2D cohort was recruited from a specialised diabetes centre. Data on smoking and alcohol use were incomplete. The cohort was ethnically homogeneous and restricted to only a single country.

DISCLOSURES:

Some authors declared receiving funding from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health and other sources. Five authors reported being employees of Steno Diabetes Center Copenhagen. One author declared receiving editorial and research support from the American Academy of Neurology, consulting for DynaMed, and performing medical legal consultations.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.