Prevalence of peripheral neuropathy among type 2 diabetes mellitus patients in a rural health centre in South India

Abstract

There is a huge burden of diabetes-related complications, both microvascular and macrovascular, in India. With the rising prevalence of diabetes mellitus (DM), this translates to an increasing number of people with complications of DM. Diabetic peripheral neuropathy (DPN) is the most common complication among DM patients with a prevalence ranging from 18.8 to 61.9% in India. Early diagnosis of DPN can reduce associated complications. Screening services at the primary healthcare level can aid early diagnosis of complications and improve health outcomes among DM patients. This study aimed to assess the prevalence of DPN and its risk factors among the type 2 DM patients attending a rural health centre. A cross-sectional study was conducted among 390 type 2 DM patients attending the Rural Health and Training Centre of Sri Ramachandra Medical College & Research Institute. Data was collected using a standardized questionnaire followed by general inspection and physical examination of the feet. Blood sample was taken to estimate HbA1c and urine sample was collected to detect presence of albumin. Among the 390 participants, 175 (44.9%) had neuropathy of which 87 (51.5%) were symptomatic. Educational status of primary schooling and less (OR = 3.34; p < 0.001), duration of DM (OR = 1.73; p = 0.038), higher HbA1c levels (OR = 2.87; p = 0.018), presence of urine albumin (OR = 2.57; p = 0.033) and peripheral vascular disease (OR = 2.85; p < 0.001) were predictors for DPN. The present study shows that the prevalence of peripheral neuropathy is high in rural areas. Regular screening using simple clinical bedside methods and affordable tools can help early identification of DPN and prevent complications like foot ulcer which ultimately leads to amputation.