A study to estimate the occurrence of peripheral neuropathy among asymptomatic type 2 diabetic patients
Keywords:Biothesiometer, Diabetic peripheral neuropathy, Michigan peripheral neuropathy screening instrument, Type 2 Diabetes Mellitus
Background: Diabetes is a life long illness characterized by increased blood glucose levels. According to International Diabetes Federation, the number of diabetes already reached 451 million in 2017 and estimated that in 2045, 693 million people will have diabetes. Approximately, 27% of the direct medical cost of diabetes may be attributed to DPN. The objectives of the current study were to estimate the occurrence of peripheral neuropathy among asymptomatic type 2 diabetic patients. The data gained from this study can aid health care providers and primary care providers to understand the occurrence of diabetic peripheral neuropathy in asymptomatic type 2 diabetic patients.
Methods: Study was conducted on patients diagnosed with Type 2 Diabetes in hospitals attached to BMCRI .It is a Cross sectional Correlational study done from February 2019 to June 2019. 88 patients who consented for the study and diagnosed with T2DM for at least a period of 5 year were included. Recently diagnosed T2DM, T1DM, pregnant female, patients on chemotherapeutic agents, known case Peripheral neuropathy of any other cause and patients not willing to participate in the study were excluded.
Results: Total 57(64.77%) males and 31(35.22%) females with mean 41.12±15 years. Patients relevant history related to of diabetic peripheral neuropathy collected and Michigan peripheral neuropathy screening instrument (MNSI) assessment done using monofilament testing and vibrotherm (table 3). It was noted that 26.13% (23) patients had objective signs of peripheral neuropathy, 17.04% were males, and female (9.09%) and p value were statistically significant <0.001.
Conclusions: Our study concluded that, 26.13% occurrence of Peripheral neuropathy in asymptomatic patients with duration of T2DM >5 years. The neuropathy was independently associated with age and duration of symptoms of diabetes prior to the diagnosis.
Goweda R, Shatla M, Alzaidi A, Alzaidi A, Aldhawani B, Alharbi H, et al. Assessment of knowledge and practices of diabetic patients regarding diabetic foot care, in Makkah, Saudi Arabia. Education. 2017;19:5.
Dikeukwu RA. The Awareness and Performance of Appropriate Foot Self-Care Practices among Diabetic Patients Attending Dr. Yusuf Dadoo Hospital. Gauteng Province, South Africa. 2012
Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF diabetes atlas: Global estimates of diabetes occurrence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271-81.
Desalu OO, Salawu FK, Jimoh AK, Adekoya AO, Busari OA, Olokoba AB, et al. Diabetic foot care: Self reported knowledge and practice among patients attending three tertiary hospital in Nigeria. Ghana Med J. 2011;45:60-5.
Gordois A, Scuffham P, Shearer A, Oglesby A, Tobian JA. The health care costs of diabetic peripheral neuropathy in the US. Diab Care. 2003;26:1790-5.
Tchanque-Fossuo CN, Wishy AM, West KI, Dawson DL, Dahle SE, Carson JG, et al. Reclaiming autologous amputated tissue for limb salvage of a diabetic foot burn with underlying critical limb ischemia. Adv Skin Wound Care. 2018;31:596-600.
Pop-Busui R, Boulton AJ, Feldman EL, Bril V, Freeman R, Malik RA, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diab Care. 2017 Jan 1;40(1):136-54.
Albers JW, Pop-Busui R. Diabetic neuropathy: mechanisms, emerging treatments, and subtypes. Curr Neurol Neurosci Reports. 2014 Aug 1;14(8):473.
Callaghan BC, Kerber KA, Lisabeth LL, Morgenstern LB, Longoria R, Rodgers A, et al. Role of neurologists and diagnostic tests on the management of distal symmetric polyneuropathy. JAMA Neurol. 2014 Sep 1;71(9):1143-9.
Oguejiofor OC, Odenigbo CU, Oguejiofor CB. Evaluation of the effect of duration of diabetes mellitus on peripheral neuropathy using the United Kingdom screening test scoring system, bio-thesiometry and aesthesiometry. Nigerian J Clini Pract. 2010;13(3):240-7.
Guy RJC, Clarke CA, Malcolm PN, Watkins PJ. Evaluation of thermal and vibration sensation in diabetic neuropathy. Diabetol. 1985;28:131-7.
World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications, Part 1. Report of a WHO Consultation. WHO Geneva. 1999.
Boulton AJM, Betts RP, Franks CI, Newrick PG, Ward JD, Duckworth T. Abnormalities of foot pressure in early diabetic neuropathy. Diabet Med 1987;4:225-8.