clinical and electrodiagnostic study of diabetic neuropathy at Jordan university hospital

ABSTRACT

To study diabetic neuropathy [DN] at Jordan University Hospital [JUH] with the aim of assessing age/gender distribution, risk factors, and other diabetic microvascular complications, clinical manifestations, results of nerve conduction studies [NCS], and treatment modalities, and to compare these findings with those from Western and other Middle/Far Eastern literatures. Among 562 patients with diabetes mellitus [DM] seen over a 2-year-period from January 2003 to January 2005, at the Diabetes center at Jordan University Hospital [JUH], 110 patients [10 DM type 1; 100 DM type 2] were studied retrospectively. The prevalence of DN was 20%. The mean age was 55.4 years [range 23-75], with 62 females and 48 males. The most common risk factors for DN were old age, long duration of DM, mean hemoglobin A1c, and hypertension. Almost 50% of patients had additional retinopathy, renal involvement, or both. The most common clinical symptoms were distal numbness/paresthesiae in the limbs [60% of patients] and the neurological examination was normal in 2/3 of patients [only 20% had stocking hypoesthesia to pain and temperature and absent ankle jerks]. The NCS showed an axonal neuropathy mainly affecting the lower limbs, especially sensory fibers [abnormal sural sensory action potential in 98% of patients]. Anticonvulsants [carbamazepine and gabapentin] were used efficiently in 50% of patients as symptomatic treatment, while tricyclic antidepressants were used as add-on in only 23 patients, due to anticholinergic side effects. In comparison with other studies, ours shows a lower prevalence of DN, similar age distribution with however, a predominance of females, similar risk factor profiles, clinical/NCS findings, and treatment modalities