Abstract
Aim: Diabetic peripheral neuropathy (DPN) is a common, severe microvascular complication of diabetes. Our study was to assess prevalence and risk factors for DPN in subjects with type 2 diabetes from 14 different countries.Methods: A total of 2,733 subjects with type 2 diabetes aged 18–65 years (45.3% men, mean duration of diabetes = 8.8 years) were included to perform this International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study in 14 countries. After a structured questionnaire was used in face-to-face interviews to collect sociodemographic characteristics and medical records of the participating subjects, laboratory tests were carried out for clinical measurement. Depressive symptoms were diagnosed and measured using the Patient Health Questionnaire-9. The potential risk factors for DPN were determined by multilevel mixed-effects logistic regression, accounting for clustering of participants within the country. Robustness of the estimates was assessed by sensitivity analysis.Results: The overall prevalence of DPN across different countries was 26.71%, whereas country-specific prevalences showed considerable variation. Multivariate analysis revealed that duration of diabetes (OR: 1.08 per 1-year increase, 95% CI: 1.06–1.09), poor glycemic control (OR: 1.11 per 1% increase in HbA1c, 95% CI: 1.05–1.18), and history of hypertension (OR: 1.58, 95% CI: 1.18–2.12), cardiovascular disease (OR: 2.07, 95% CI: 1.55–2.78) and depressive symptoms (OR: 1.92, 95% CI: 1.43–2.58) were independently and positively associated with the risk of DPN. Sensitivity analyses including or excluding patients from countries with extreme low or high prevalence of DPN yielded similar estimates in terms of trend and magnitude.Conclusions: This international study illustrates that more than a quarter of individuals with type 2 diabetes developed DPN. The prevalence was positively associated with the duration of diabetes, poor glycemic control, and history of hypertension, cardiovascular disease and depressive symptoms.
Highlights
Diabetes mellitus is a major public health issue
A sample of consecutive outpatient clinic attenders with type 2 diabetes mellitus (T2DM) at each of the study sites were invited by the treating physician or diabetologist in the diabetes clinics to participate in the study between September 2013 and May 2015, with the purpose of enrolling a total of 200 T2DM patients in each country
A total of 2,733 participant aged 18–65 years were included in estimating the overall prevalence of Diabetic peripheral neuropathy (DPN)
Summary
Diabetes mellitus is a major public health issue. An estimated 451 million people were diagnosed with diabetes worldwide in 2017, and the number will increase to 693 million by 2045 [1]. Compared with other chronic diseases, diabetes causes greater mortality, morbidity, disability and financial loss due to its complications [2]. Diabetic peripheral neuropathy (DPN) is one of the most common and severe microvascular complications of diabetes [3]. As a major contributor to peripheral nerve injury [4], DPN impairs quality of life and potentiates risks of disability in diabetic subjects [5]. The prevalence and the risk factors of DPN on a global scale, especially in low- and middleincome countries, remain unclear
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
