Jurado J et al. – In the series, heterozygous angiotensin–converting enzyme (ACE) polymorphism (D/I) stands as a protective factor for diabetic peripheral neuropathy (DPN) development. Accumulated incidence of DPN was relevant. Further prospective studies are warranted.

• Longitudinal study with annual follow-up for 3years involving a group of T2DM (N=283) randomly selected.
• ACE gene polymorphism distribution (I=insertion; D=deletion) was determined.
• DPN was diagnosed using clinical and neurophysiology evaluation.

• Baseline DPN prevalence was 28.97% (95% CI, 23.65–34.20).
• ACE polymorphism heterozygous genotype D/I presence was 60.77% (95% CI, 55.05–66.5) and was independently associated with a decreased risk of DPN (RR, 0.51; 95% CI, 0.30–0.86).
• DPN correlated with age (P<0.001) but not with gender (P=0.466) or time of evolution of T2DM (P=0.555).
• Regarding end point, DPN prevalence was 36.4% (95% CI, 30.76–42.04), and accumulated incidence was 10.4% 3years thereafter.
• In the final Poisson regression analysis, the presence of heterozygous genotype remained independently associated with a decreased risk of DPN (RR, 0.71; (95% CI, 0.53–0.96).
• DPN presence remained correlated with age (P=0.002), but not with gender (P=0.490) or time of evolution (P=0.630).