Shashi Sharma,1,2 Rae Kamikawa,2 Orion Goodman,2 Belinda Lim,2 Janette Bow-Keola,1,2 Matthew Kao,1,2 Tyrone John Sumibcay,1,2 Natalia Gonzalez,2 Enrique Carrazana,1 Kore Kai Liow1,2

1 John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI

2 ALS and Neuromuscular Center, Hawaii Pacific Neuroscience, Honolulu, HI

Peripheral neuropathy is a form of nerve damage that often causes pain, numbness, or weakness in the limbs and is commonly associated with diabetes. Although diabetes rates are reported to be higher among Native Hawaiians and Other Pacific Islanders (NHOPI), little is known about how the prevalence of peripheral neuropathy varies across racial groups. This study examines how diabetes prevalence and clinical features differ by race among patients with peripheral neuropathy in Hawai’i. We conducted a retrospective chart review of 375 patients seen between 2013 and 2025 at a private outpatient neurology clinic. Race and ethnicity were self-reported, and diabetes status was identified through ICD-10 codes and provider documentation. We used descriptive statistics and chi-squared tests to compare diabetes prevalence across racial groups. Diabetes was significantly more common among Native Hawaiians (35.9%) and Other Pacific Islanders (57.1%) compared to White (11.3%) and Asian patients (16.7%) (p = 0.0000277). Diabetic patients also had higher rates of clinical findings consistent with known patterns of diabetic neuropathy: less frequent torso/back symptoms (8.0% vs. 79.7%), more lipid abnormalities (73.3% vs. 42.0%), and greater loss of pinprick (45.3%), vibration (41.3%), and proprioception (26.7%) senses. These findings reflect both small and large-fiber involvement typical of diabetic neuropathy. The elevated diabetes prevalence and neuropathy burden in NHOPI patients suggest a disparity in disease progression and care needs. Targeted screening and culturally informed interventions may help improve outcomes. Limitations include the single-clinic setting, small subgroup sizes, and lack of control for age and socioeconomic status.