In an attempt to identify the potential risk factors for diabetic neuropathy in patients recently diagnosed as diabetics, 742 non-insulin-dependent diabetics under 70 years of age who had been diagnosed as diabetics less than 5 years before the initial visit were examined in a cross-sectional study conducted at a university hospital. Neuropathy was defined as the presence of symptoms consistent with distal polyneuropathy, or the absence of tendon reflexes. Of the patients, 21% displayed neuropathy in this study, with no differences between the genders. Age was higher, duration of diabetes was longer, body mass index was lower, and fasting plasma glucose level was higher in patients with neuropathy than in those without neuropathy, for both genders. Body height, maximal body mass index, ethanol use, smoking status, systolic and diastolic blood pressure and serum cholesterol level did not differ between the two groups. Logistic regression analysis showed that fasting plasma glucose level (χ² = 28.2) was a major determinant for neuropathy independent of diabetes duration (9.5), age (6.2) and maximal body mass index (3.9). Tight glycemic control from the onset of diabetes was concluded to be essential for the prevention of diabetic distal polyneuropathy.