To evaluate the burden of diabetes among Native Hawaiian and Other Pacific Islander (NHOPI) patients with peripheral neuropathy in Hawai‘i and to characterize neuropathy features and comorbidities associated with diabetes compared to non-diabetic individuals.

Peripheral neuropathy, a common complication of diabetes, leads to pain, numbness, and sensory loss in the limbs. Native Hawaiians and Other Pacific Islanders (NHOPI) experience disproportionately high rates of diabetes, yet neuropathy patterns across racial groups in Hawai‘i remain understudied.

We performed a retrospective chart review of 375 patients diagnosed with peripheral neuropathy between 2013 and 2025 at a private outpatient neurology clinic. Race and ethnicity were self-reported, and diabetes status was determined using ICD-10 codes and provider documentation. Statistical comparisons were made between diabetic and non-diabetic patients and across racial/ethnic groups.

Diabetes was significantly more common among NHOPI patients (Native Hawaiian: 35.9%; Other Pacific Islander: 57.1%) compared with White (11.3%) and Asian (16.7%) patients (p = 2.77e-05). Diabetic patients exhibited features of both small- and large-fiber neuropathy, including higher rates of pinprick (45.3%), vibration (41.3%), and proprioception (26.7%) loss. They reported fewer torso or back symptoms (8.0% vs. 79.7%) but more frequent metabolic comorbidities, particularly lipid abnormalities (73.3% vs. 42.0%).

These findings demonstrate a disproportionate burden of diabetes-related neuropathy among NHOPI populations and emphasize the need for earlier screening and culturally tailored interventions. Study limitations include the single-clinic design, small subgroup sizes, and a lack of adjustment for demographic and socioeconomic factors.