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Introduction@#Diabetes Mellitus is a chronic non-communicable disease that has been increasing in prevalence worldwide. Preventing and treating diabetes and its complications have been a burden in the health care system. Diabetic neuropathy is its frequent complication and in the long run, is associated with a negative impact on the functioning and quality of life. Hence, its early detection can prevent and delay its sequelae and improve patients’ quality of life.@*Objective@#To determine the prevalence and burden of neuropathy among diabetic patients of Eastern Visayas Regional Medical Center (EVRMC) Family Medicine Diabetes Wellness Clinic@*Methods@#This was an analytical cross-sectional study. Patients at the EVRMC Family Medicine Diabetes Wellness Clinic from May to October 2020 were included. The Michigan Neuropathy Screening Instrument was used to diagnose diabetic neuropathy. Descriptive statistics, Chi-square test, and Fisher’s exact test were used to determine the association between socio-demographic profile and clinical characteristics among neuropathic patients.@*Results@#Two hundred ten patients were enrolled. Majority were female (66.7%), ≥60 years old (58.1%), with vocational/college degrees (37.1%), unemployed (75.2%), did not have glycemic control (80%), had diabetes for ≤5 years (57.1%), and took two maintenance medications (46.7%). Biguanide was the most common maintenance drug (70.5%). Among diabetic patients, 30.5% had neuropathy. Statistically significant associations were seen in ≥60 years old [OR 1.92, p=0.04], with vocational/ college degrees [OR 2.17, p=0.01], and with diabetes for 6-10 years [OR 2.42, p=0.01] and ≥20 years [OR 5.07, p=0.01.@*Conclusion@#Diabetes Mellitus was prevalent in elderly age group, female gender, with vocational/college degrees, and unemployed. Most had uncontrolled sugar, had diabetes for ≤5 years, and took two maintenance drugs. Only 30.5% had neuropathy. Diabetic patients ≥60 years old, had vocational/college degrees, and had longer duration of the disease had higher odds of having diabetic neuropathy.
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Diabetes Mellitus , Diabetic NeuropathiesABSTRACT
Introduction: The burden of diabetes mellitus (DM) is on the rise especially in developing countries like India. Due to its chronic nature DM tends to cause many debilitating complications and diabetic peripheral neuropathy (DPN) is one of them. The aim of this study is to determine the prevalence of DPN among patients attending a tertiary care hospital and to identify the determinants associated with it. Materials and methods: A cross-sectional study was conducted in diabetic patients attending a tertiary care hospital in Kancheepuram district of Tamil Nadu from May 2018 till September 2018. A total of 203 diabetic patients were asked to respond to the patient history version of Michigan neuropathy screening Instrument and examinations were conducted after obtaining consent from them. The data were analyzed in terms of descriptive statistics as well as bivariate analysis. Results: The prevalence of DPN using the MNSI history version and MNSI examination were found to be 31% and 24% respectively. The major determinants were found to be age more than 50 years (OR: 0.24, CI: 0.123- 0.467), P<0.00001, HbA1C > 6.5 (OR: 0.467, CI: 1.90 – 0.356, P= 0.05). Conclusions: This study showed that the prevalence of peripheral neuropathy among diabetic patients was 41.5% and the major determinants were age more than 50 years and poor HbA1C control. Early detection through routine screening and regular follow up examinations will reduce the burden of disability among diabetics and improve their quality of life significantly
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Objective To observe the clinical efficacy of electronic moxibustion in treating diabetic peripheral neuropathy due to liver-kidney deficiency. Method Ninety patients with diabetic peripheral neuropathy due to liver-kidney deficiency were randomized into a treatment group of 44 cases and a control group of 46 cases. The treatment group was intervened by acupoint therapy by warm electronic moxibustion, while the control group was intervened by foot bath with Chinese medication. For both groups, 10 treatment sessions were taken as a course of treatment, for 3 courses in total. Before and after the treatment, the whole blood viscosity, blood lipids, fasting blood glucose (FBG), glycosylated hemoglobin (GHb) and Michigan Neuropathy Screening Instrument (MNSI) were evaluated in the two groups. Result The whole blood viscosity indexes, blood lipids levels, FBG level and GHb level didn't show significant differences after the treatment in the two groups (P>0.05). The intra-group and inter-group comparisons of MNSI score showed significant differences after the treatment (P<0.01); there was a between-group difference in the change of MNSI score after the treatment (P<0.01). Conclusion Electronic moxibustion is an effective approach in treating diabetic peripheral neuropathy.
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Objective To investigate the clinical efficacy of electronic moxibustion in treating diabetic peripheral neuropathy (liver-kidney deficiency type).Methods Ninety patients with diabetic peripheral neuropathy (liver-kidney deficiency type) were randomized to a treatment group (44 cases) and a control group (46 cases).The treatment group received electronic moxibustion and the control group,Chinese herbal fumigation of feet.Both groups were treated 10 times as a course for a total of three courses.The TCM symptom total score and the Michigan Neuropathy Screening Instrument (MNSI) score were recorded in the two groups before and after treatment.The clinical therapeutic effects were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the TCM symptom total score in both groups after one,two and three courses of treatment (P＜0.01).The TCM symptom total score improvement rate was (60.9±16.7)％ in the treatment group and (56.6±19.2)％ in the control group;there was a statistically significant difference between the two groups (P＜0.01).The total efficacy rate was 97.7％ in the treatment group and 95.7％ in the control group;there was no statistically significant difference between the two groups (P＞0.05).The pre-/post-treatment MNSI score difference value was (2.98±3.66) in the treatment group and (0.78±2.92) in the control group;there was a statistically significant difference between the two groups (P＜0.01).Conclusions Electronic moxibustion is an effective way to treat diabetic peripheral neuropathy.Its therapeutic effect is slightly better than that of Chinese herbal fumigation.
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Background: Neuropathy is a common complication of diabetic patients. Aim: To determine the prevalence of diabetic peripheral neuropathy in Type 2 diabetic patients attended at a family medicine unit. Material and Methods: Cross-sectional assessment of 348 type 2 diabetic patients aged 34-89 years (60% females) with a disease duration of 5 to 15 years. Peripheral neurological status was evaluated using The Michigan Neuropathy Screening Instrument, a tool that includes a self-assessment of symptoms and a physical examination. Results: Diabetic neuropathy was found in 240patients (69%). The prevalence in males and females was 72 and 67% respectively. The prevalence in patients with a disease duration of 5, 10 and 15 years, was 59, 69 and 77%, respectively. Fifty percent of patients with neuropathy complained of dry skin, 2% had ulcers, 43% had an abnormal perception of vibration and 29% had an abnormal monofilament test. Conclusions: The overall prevalence of peripheral neuropathy in this group of patients was 69% and was directly associated with the duration of the disease.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , /complications , Diabetic Neuropathies/epidemiology , Age Distribution , Cross-Sectional Studies , Diabetic Neuropathies/diagnosis , Diabetic Neuropathies/etiology , Prevalence , Risk Factors , Sensitivity and SpecificityABSTRACT
BACKGROUND: Diabetic neuropathy is a common complication of diabetes. Since neuropathy leads to ulceration and amputation, efforts to detect early and to elucidate its risk factors are ongoing. The goal of this study was to check the validity of Michigan neuropathy screening instrument (MNSI) as a screening test and its risk factors for diabetic neuropathy. METHODS: A total of 75 subjects with type II diabetes mellitus, who visited a university hospital, were investigated. We measured their duration of diabetes, height, weight, systolic blood pressure, diastolic blood pressure, fasting glucose, glycosylated hemoglobin, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, serum creatinine, and 24-h urine albumin. MNSI tested and electrophysiological test were performed. RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of MNSI was 63.5%, 78.3%, 86.8%, and 48.6%, respectively. Statistically significant relationships were found between neuropathy and the duration of diabetes and total cholesterol. CONCLUSION: MNSI seemed to be an appropriate screening test for diabetic neuropathy. More attention must be paid to the duration of diabetes and the total cholesterol of type 2 diabetic patients with peripheral neuropathy.