The prevalence of diabetic neuropathy in Greenland and its association with Inuit genetic ancestry - a cross-sectional study

AIMS: Data on diabetic neuropathies in Greenland remains limited. The aim was to estimate the prevalence of diabetic peripheral neuropathy (DPN) and cardiovascular autonomic neuropathy (CAN) among Greenlanders with diabetes and prediabetes and investigate whether Inuit ancestry contributes to higher susceptibility.

METHODS: Individuals with diabetes and prediabetes from the Greenland Population Survey 2018 were examined for DPN (Vibration Perception Threshold (VPT) and light pressure) and CAN (Cardiovascular Reflex Tests and Heart Rate Variability). Inuit genetic admixture was included as a determinant in regression models adjusted for age, sex, genetics, diabetes status and residency.

RESULTS: Among 447 participants (1/3 diabetes, median age 61, 57 % female) DPN prevalence was 28 % in diabetes and 25 % in prediabetes. CAN prevalence was 24 % and 15 %, respectively. A 20-percentage point change in Inuit ancestry was associated with a 4 % higher VPT (coefficient: 1.04, 95 % CI: 1.003-1.08) and 51 % higher odds of CAN (OR: 1.51, 95 % CI: 1.09-2.08).

CONCLUSIONS: DPN and CAN are common among Greenlanders with diabetes and prediabetes, highlighting the need for improved diagnostics and prevention. The association between Inuit genetic ancestry and neuropathy suggests a predisposition to neuropathy among Inuit, which may be explained by both genetic and lifestyle factors.