Study of prevalence and determinants of peripheral neuropathy in patients with type 2 diabetes mellitus

Abstract

Background: India is witnessing a depressing situation due to escalating incidence and prevalence of type 2 diabetes mellitus (T2DM) and its inevitable outcomes of cardiovascular diseases (CVD), diabetic neuropathy, nephropathy and retinopathy. Present study was aimed to investigate peripheral neuropathy in adult patients with type 2 diabetes. Material and Methods: Present study was hospital based, prospective, observational study conducted in subjects recruited from the diabetes OPD of both gender ≥ 30 years, known case of type 2 diabetes mellitus. The screening for DPN was conducted using the Michigan Neuropathy Screening Instrument (MNSI). Results: In present study, 256 subjects satisfying study criteria were considered for study. Most of patients were from 51-65 years age group (39.8%) followed by 31-50 years age group (37.1%). Male subjects (54.3%) were more than females (45.7%). Mean duration of type 2 diabetes mellites was 10.6 ± 6.3 years. Mean HbA1c was 9.3 ± 2.8% and 65.6% had HbA1c≥7%. Common high risk factors were hypertension (52.3%), alcoholic > 60 mg/day (30.5%), BMI > 30kg/m2 (26.6%), smoking habits >1 pack/day (18.0 %), history of peripheral artery disease (12.5 %) and history of prior ulcer (12.1%). Prevalence of peripheral neuropathy in subjects with type 2 diabetes mellitus in present study was 35.2%, calculated as per reduced perception/absent monofilament test. Vibration perception test was absent in 22.7 % subjects and ankle reflex was absent in 13.3 % subjects. Age, duration of diabetes, fasting blood sugar, BMI, HbA1c ≥ 7 % and alcoholic (> 60 mg/day) were statistically significant in subjects of type 2 diabetes mellitus with peripheral neuropathy and difference was statistically significant. Conclusion: Diabetic peripheral neuropathy was significantly and positively associated with age, duration of diabetes, fasting blood sugar, BMI, HbA1c ≥ 7 % and alcoholic (> 60 mg/day). Regular screening of patients with diabetes mellitus for peripheral neuropathy may be recommended for early diagnosis and treatment.