DOI: http://dx.doi.org/10.18203/2349-3933.ijam20194137

Prevalence of peripheral neuropathy and peripheral artery disease in diabetic patients attending a tertiary care hospital

Sangeetha Meena, Manikandan R. C.

Abstract


Background: Foot complications are one of the most devastating complications among diabetes all over the world. Both Diabetic Peripheral Neuropathy (DPN) and Peripheral Artery Disease (PAD) are responsible for diabetic foot complications. Aim of this study is to screen diabetic patients for both DPN and PAD.

Methods: This is a cross-sectional study covering 200 diabetic patients attending a Teaching Hospital. Prevalence of DPN was assessed using Biothesiometer and PAD by measuring the Ankle Brachial Index using handheld Doppler.

Results: 49.5% had DPN and 19.5% had PAD. 13% had both PAD and DPN. Most of the subjects were in 51-60 years age group constituting 36.5 %. 61.5% were females. 69.5% had diabetes for more than 10 years. 88% had their HbA1C of more than 6.5%.

Conclusions: The prevalence of PVD is multi-fold higher in patients with diabetes with smoking, hyperglycemia, hypertension, dyslipidemia, as major risk factors. Ankle, brachial pressure index, is useful in identifying PVD and it needs further evaluation by an arterial color Doppler and digital subtraction angiography.

Keywords


Biothesiometer, Diabetic peripheral neuropathy, Diabetes mellitus, Doppler evaluation, Peripheral artery disease

Full Text:

PDF

References


Muthiah A, Kandasamy R, Nagulan S, Madasamy A. A study on diabetic foot and its association with peripheral artery disease. Int. Surg. J. 2017 Apr;4(4):1217-21.

American Diabetes Association. Peripheral arterial disease in people with diabetes. Diabetes Care. 2003;26(12):3333-41.

Basal V, Kalita J, Misra UK. Diabetic Neuropathy. Postgrad Med J. 2006; 82(964):95-100.

Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol. 2012 Jun 1;11(6):521-34.

Escobar C, Blanes I, Ruiz A, Vinuesa D, Montero M, Rodríguez M, et al. Prevalence and clinical profile and management of peripheral artery disease in elderly patients with diabetes’. 2018 March;9(5)133-5.

Martin CL, Waberski BH, Pop-Busui R, Cleary PA, Catton S, Albers JW, et al. DCCT/EDIC Research Group. Vibration perception threshold as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes: results from the DCCT/EDIC study. Diabetes care. 2010 Dec 1;33(12):2635-41.

Oduor PR, Ondari NJ. The Prevalence of the diabetic foot at risk (diabetic foot neuropathy and Peripheral Vascular disease in a selected Kenyan population International J Scientific Research and Innovative Technol. 2016;(3)2313-3759.

Duane R. Hennion MD. Diagnosis, and Treatment of Peripheral Arterial Disease. Am fam Physician. 2013 Sep 1;88(5):306-10.

Fowler M. Microvascular and macrovascular complications of diabetes. Clinical Diabetes. 2008;26(2):77-82.

Griffin SJ, Borch-Johnsen K, Davies MJ. Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening a cluster-randomized trial. Lancet. 2011;378:156-67

Hadi H, Suwaidi J. Endothelial dysfunction in diabetes mellitus. Vascular Health and Risk Management. 2007;3(6):853-76.

Kasalova Z. Biothesiometry in the diagnosis of Peripheral neuropathies’ Cas Lek Cesk. 2002 Apr 12;141(7):223-5.

McDermott MM, Greenland P, Liu K, Guralnik JM, Criqui MH, Dolan NC, et al. Leg symptoms in peripheral arterial disease. JAMA. 2001;286(13):1599-606.

Charles M, Ejskjaer N, Witte DR, Borch-Johnsen K, Lauritzen T, Sandbaek A. Prevalence of Neuropathy and Peripheral Arterial Disease and the Impact of Treatment in People with Screen Detected Type 2 Diabetes. Diabetes care. 2011 Oct;34(10):2244-9.

Jayaprakash P, Bhansali A, Bhansali S, Dutta P, Anantharaman R, Shanmugasundar G, et al. Validation of bedside methods in evaluation of diabetic peripheral neuropathy. IJMR. 2011 Jun;133(6):645.

Pradeep Battula. Prevalence of sensory Peripheral Neuropathy in diabetic patients at diabetes care center: a care sectional study’ Int J. Res med Sci. 2017 Sep;5(9):4066-71.

Okello S, Millard A, Owori R, Asiimwe AB, Siedner MJ, Rwebembera J. Prevalence of lower extremity PAD among adult diabetic patients in southwestern Uganda-BMC Cardiovascular disorders. 2014 June 10:14:75.