Iberoamerican Journal of Medicine
https://iberoamjmed.com/article/doi/10.5281/zenodo.4393501
Iberoamerican Journal of Medicine
Original article

Prevalence and Determinants of Diabetic Peripheral Neuropathy/Foot Syndrome in the Rural Population of North India

MD Abu Bashar, Madhur Verma

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Abstract

Introduction: Diabetic peripheral neuropathy (DPN), a common and troublesome complication of diabetes mellitus (DM), leads to a higher risk of diabetic foot ulcers and lower limb amputation. This study aimed to assess the prevalence of DPN among patients of type 2 DM from rural North India and associated risk factors for the condition.
Materials and Methods: A facility-based cross-sectional study was carried out among type 2 diabetic patients attending the Non-Communicable Diseases (NCD) clinic of a secondary care hospital in rural North India. A questionnaire that included sociodemographic details, clinical and laboratory parameters, and the Michigan Neuropathy Screening Instrument (MNSI) for detecting peripheral neuropathy was administered to 100 consecutive eligible patients. Statistical Package for Social Sciences (SPSS) version 25.0 was used for entering and analyzing data. Bivariate analysis was performed to determine the factors significantly associated with the presence of DPN.
Results: The prevalence of DPN was found to be 42.0%. Male gender, advancing age (≥60 years), longer duration of diabetes (>10 years), smoking, physical inactivity, obesity, uncontrolled blood pressure, poor glycemic control and altered lipid profile were found to be significantly associated with the presence of DPN.
Conclusions: The prevalence of DPN among type 2 diabetes patients from rural northern India is alarmingly high. There is a need for essential screening of all diabetic patients by their primary care provider for early detection of DPN, particularly in rural India.

Keywords

Diabetes; Neuropathy; MNSI; Rural; North India

References

1. International Diabetes Federation. IDF Diabetes Atlas. 9th. 2020.
2. World health Organization. Top 10 causes of death. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death (accessed Oct 2020).
3. Alexiadou K, Doupis J. Management of diabetic foot ulcers. Diabetes Ther. 2012;3(1):4. doi: 10.1007/s13300-012-0004-9.
4. Forlee M. What is the diabetic foot? The rising prevalence of diabetes worldwide will mean an increasing prevalence of complications such as those of the extremities. Contin Med Educ. 2010;28(4):152-6.
5. Jain AKC, Vishwanath S. Studying major amputations in a developing country using Amit Jain’s typing and scoring system for diabetic foot complications - time for standardization of diabetic foot practice. Int Surg J. 2015;2(1):26-30. doi: 10.5455/2349-2902.isj20150205.
6. Papanas N, Maltezos E. The diabetic foot: a global threat and a huge challenge for Greece. Hippokratia. 2009;13(4):199-204.
7. Eleftheriadou I, Kokkinos A, Liatis S, Makrilakis K, Tentolouris N, Tentolouris A, Tsapogas P. Atlas of the diabetic foot. 3rd ed. Wiley-Blackwell; 2019.
8. Lee PG, Damschroder LJ, Holleman R, Moin T, Richardson CR. Older Adults and Diabetes Prevention Programs in the Veterans Health Administration. Diabetes Care. 2018;41(12):2644-7. doi: 10.2337/dc18-1141.
9. Bus SA, van Netten JJ. A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable. Diabetes Metab Res Rev. 2016;32 Suppl 1:195-200. doi: 10.1002/dmrr.2738.
10. George H, Rakesh P, Krishna M, Alex R, Abraham VJ, George K, Prasad JH. Foot care knowledge and practices and the prevalence of peripheral neuropathy among people with diabetes attending a secondary care rural hospital in southern India. J Family Med Prim Care. 2013;2(1):27-32. doi: 10.4103/2249-4863.109938.
11. Moghtaderi A, Bakhshipour A, Rashidi H. Validation of Michigan neuropathy screening instrument for diabetic peripheral neuropathy. Clin Neurol Neurosurg. 2006;108(5):477-81. doi: 10.1016/j.clineuro.2005.08.003.
12. Bus SA, van Netten JJ, Lavery LA, Monteiro-Soares M, Rasmussen A, Jubiz Y, Price PE; International Working Group on the Diabetic Foot. IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev. 2016;32 Suppl 1:16-24. doi: 10.1002/dmrr.2696.
13. Sun J, Wang Y, Zhang X, Zhu S, He H. Prevalence of peripheral neuropathy in patients with diabetes: A systematic review and meta-analysis. Prim Care Diabetes. 2020;14(5):435-44. doi: 10.1016/j.pcd.2019.12.005.
14. Sendi RA, Mahrus AM, Saeed RM, Mohammed MA, Al-Dubai SAR. Diabetic peripheral neuropathy among Saudi diabetic patients: A multicenter cross-sectional study at primary health care setting. J Family Med Prim Care. 2020;9(1):197-201. doi: 10.4103/jfmpc.jfmpc_927_19.
15. Braffett BH, Gubitosi-Klug RA, Albers JW, Feldman EL, Martin CL, White NH, et al. 2020;69(5):1000-10. doi: 10.2337/db19-1046.
16. Shiferaw WS, Akalu TY, Work Y, Aynalem YA. Prevalence of diabetic peripheral neuropathy in Africa: a systematic review and meta-analysis. BMC Endocr Disord. 2020;20(1):49. doi: 10.1186/s12902-020-0534-5.
17. Perrin BM, Allen P, Gardner MJ, Chappell A, Phillips B, Massey C, et al. The foot-health of people with diabetes in regional and rural Australia: baseline results from an observational cohort study. J Foot Ankle Res. 2019;12:56. doi: 10.1186/s13047-019-0366-6.
18. Kaewput W, Thongprayoon C, Rangsin R, Jindarat S, Narindrarangkura P, Bathini T, et al. The Association between Serum Uric Acid and Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus: A Multicenter Nationwide CrossSectional Study. Korean J Fam Med. 2020;41(3):189-94. doi: 10.4082/kjfm.18.0205.
19. Yang Q, Zhang Y, Zeng Q, Yang C, Shi J, Zhang C, et al. Correlation Between Diabetic Peripheral Neuropathy and Sarcopenia in Patients with Type 2 Diabetes Mellitus and Diabetic Foot Disease: A Cross-Sectional Study. Diabetes Metab Syndr Obes. 2020;13:377-86. doi: 10.2147/DMSO.S237362.
20. Qin L, Niu JY, Zhou JY, Zhang QJ, Zhou F, Zhang N, et al. [Prevalence and risk factors of diabetic peripheral neuropathy in Chinese communities]. Zhonghua Liu Xing Bing Xue Za Zhi. 2019;40(12):1578-84. doi: 10.3760/cma.j.issn.0254-6450.2019.12.014.
21. 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. Diabetes Care. 2017;40(1):136-54. doi: 10.2337/dc16-2042.
22. Barrett EJ, Liu Z, Khamaisi M, King GL, Klein R, Klein BEK, et al. Diabetic Microvascular Disease: An Endocrine Society Scientific Statement. J Clin Endocrinol Metab. 2017;102(12):4343-410. doi: 10.1210/jc.2017-01922.
23. van der Velde JHPM, Koster A, Strotmeyer ES, Mess WH, Hilkman D, Reulen JPH, et al. Cardiometabolic risk factors as determinants of peripheral nerve function: the Maastricht Study. Diabetologia. 2020;63(8):1648-58. doi: 10.1007/s00125-020-05194-5.
24. Huang L, Zhang Y, Wang Y, Shen X, Yan S. Diabetic Peripheral Neuropathy Is Associated With Higher Systolic Blood Pressure in Adults With Type 2 Diabetes With and Without Hypertension in the Chinese Han Population. Can J Diabetes. 2020;44(7):615-23. doi: 10.1016/j.jcjd.2019.11.005.
25. Javed S, Hayat T, Menon L, Alam U, Malik RA. Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late. Diabet Med. 2020;37(4):573-9. doi: 10.1111/dme.14194.


Submitted date:
11/03/2020

Reviewed date:
11/19/2020

Accepted date:
12/21/2020

Publication date:
12/25/2020

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