Diabetic neuropathy; prevalence and risk factors for severity in patients with type 2 diabetes mellitus attending diabetic clinic of Ghulam Mohammad Mahar Medical College Hospital, Sukkur

ABSTRACT

To estimate the prevalence of diabetic neuropathy [severity wise] and associated risk factors in patients having type 2 diabetes mellitus. A cross-sectional study. Diabetes Clinic, Ghulam Mohammad Mahar Medical College Hospital, Sukkur. From January 2009 to December 2011. A patients based sample of 1401 persons with diabetes [identified as per the WHO criteria] underwent comprehensive eye examination including direct and indirect Fundoscopy for diabetic retinopathy grading. Vibration perception threshold [VPT] measurements were done to assess neuropathy [cut off >/= 20 V]. Severity of neuropathy was graded into three groups based on VPT score as mild [20-24.99 V], moderate [25-38.99 V], and severe [>/= 39 V]. Univariate and multivariate analyses were done to find out the independent risk factors for severity of diabetic neuropathy. In the overall group, the prevalence of diabetic neuropathy was 18.84% [95% CI 16.79-20.88]. The prevalence of mild diabetic neuropathy was 7.9% [95 CI 6.50-9.33], and severe diabetic neuropathy was 5% [95% CI 3.86-6.14]. Increasing age per year [P<0.0001] was a statistically significant risk factor for all - mild, moderate, and severe - types of diabetic neuropathy. For severe diabetic neuropathy, other significant risk factors were duration of diabetes mellitus [P=0.027], macroalbuminura [P=0.001], and presence of diabetic retinopathy [P=0.020]. The results suggested that every fifth individual in a population of type 2 diabetes is likely to have diabetic neuropathy. Nearly 13% had neuropathy of moderate and severe category, making this group vulnerable for complications such as foot ulceration or lower limb amputation