Abstract
Background: The prevalence of diabetes in Pakistan is 11.45%. The reported prevalence of diabetic foot ulceration in Pakistan is between 4% and 10%, with the amputation rate of 8% - 21%. Peripheral neuropathy and vasculopathy are main underlying cause of diabetic foot ulcers. Methodology: It was a cross-sectional non-interventional cohort study where all newly diagnosed treatment naïve type 2 diabetic patients were enrolled. Peripheral neuropathy and vasculopathy were detected by Michigan neuropathy screening instrument (MNSI) and ankle brachial index (ABI) respectively. Risk factors for peripheral neuropathy and vasculopathy were determined by univariate and multivariate logistic regression analysis. Statistical significance was considered with P value of ïve patients of type 2 DM. Age, duration of symptoms prior to diagnosis, metabolic parameters like raised HbA1C, hyperlipidemia and spot random albumin creatinine ratio are found to be risk factors for both peripheral neuropathy and vasculopathy.
Highlights
The increasing global prevalence of diabetes has been estimated about 8.5% [1]
Peripheral neuropathy and vasculopathy were detected by Michigan neuropathy screening instrument (MNSI) and ankle brachial index (ABI) respectively
The current study has shown significant association of hyperlipidemia where it is found to be a risk factor for peripheral neuropathy when compared between patients with and without peripheral neuropathy
Summary
The increasing global prevalence of diabetes has been estimated about 8.5% [1]. Prevalence of diabetes has more rising trend in middle- and low-income countries as reported by World Health Organization. The reported prevalence of diabetic foot ulceration in Pakistan is between 4% and 10%, with the amputation rate of 8% - 21%. Age (Odd ratio 1.07 (1.02 - 1.11), p 0.003), duration of symptoms (Odd ratio 1.11 95% CI: 1.05 - 1.17, p ≤ 0.001), high HbA1C % (Odd ratio 1.94 95% CI: 1.54 - 2.45, P ≤ 0.001), albumin creatinine ratio (Odd ratio 1.01, 95% CI: 1.00 - 1.01, P ≤ 0.001 ) and cholesterol level (Odd ratio 1.01 95% CI: 1.01 - 1.02, p = 0.001) were found as risk factors for early neuropathy and vasculopathy. Conclusion: Peripheral neuropathy and vasculopathy are frequently reported complications among newly diagnosed treatment naïve patients of type 2 DM. Duration of symptoms prior to diagnosis, metabolic parameters like raised HbA1C, hyperlipidemia and spot random albumin creatinine ratio are found to be risk factors for both peripheral neuropathy and vasculopathy
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