Diabetic Peripheral Neuropathy and its Risk Factors among Chronic Diabetic Patients in Southern Karnataka, India

Sneha Sri GR; Darshan BB; Aryan MG; Waseem Anjum; Damayanthi MN

doi:10.55489/njcm.150820243769

Authors

Sneha Sri GR Chamarajanagar Institute of Medical Sciences, Chamarajanagar, Karnataka, India https://orcid.org/0009-0009-3879-492X
Darshan BB Chamarajanagar Institute of Medical Sciences, Chamarajanagar, Karnataka, India https://orcid.org/0000-0003-2365-7534
Aryan MG Chamarajanagar Institute of Medical Sciences, Chamarajanagar, Karnataka, India https://orcid.org/0009-0008-1468-8412
Waseem Anjum Chamarajanagar Institute of Medical Sciences, Chamarajanagar, Karnataka, India
Damayanthi MN Chamarajanagar Institute of Medical Sciences, Chamarajanagar, Karnataka, India https://orcid.org/0009-0004-9071-1558

DOI:

https://doi.org/10.55489/njcm.150820243769

Keywords:

Diabetic Peripheral Neuropathy, Michigan Neuropathy Screening Instrument (MNSI), Risk factors, Tobacco, Multivariate-analysis

Abstract

Background: The global prevalence of diabetes mellitus (DM) was 10.5% (2021). The common complications of DM include diabetic peripheral neuropathy (DPN) which affects 30% to 50% of diabetics. DPN is a debilitating complication of diabetes that significantly impairs the quality of life of individuals. Objectives: To estimate the magnitude of DPN using Michigan Neuropathy Screening Instrument (MNSI) and to determine the factors associated with it.

Methodology: A facility based cross-sectional study was conducted among 100 participants with diabetes for more than 5years. Questionnaire included sociodemographic details, diabetes history, co-morbidities, personal habits, MNSI patient and clinical version for detecting DPN. Bivariate analysis was performed to determine the factors associated with DPN; multivariate analysis to determine the exact factors affecting DPN.

Results: Proportion of DPN was 34% & 38% on MNSI interview and examination version respectively. Factors affecting DPN were age, tobacco consumption, age of diagnosis of DM, co-morbidities on bivariate analysis. Tobacco consumption [AOR- 6.72, CI-2.07-21.8, P=0.002] & co-morbidities [AOR- 7.19, CI-1.93-26.7, P=0.003] on multivariate analysis.

Conclusion: Proportion of DPN remains high among individuals with diabetes. Smoking & presence of co-morbidities contributes to an increased risk of DPN.

References

The top 10 causes of death. World Health Organization, Fact sheets. 2019 [Internet] [Accessed on 2023 August 21]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

Non communicable diseases. Who.int. 2019 [Accessed on 2023 August 21]. Available from: https://www.who.int/news-room/factsheets/detail/noncommunicable-disease

Pradeepa R, Mohan V. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021;69(11):2932-2938. Doi: https://doi.org/10.4103/ijo.IJO_1627_21 PMid:34708726 PMCid:PMC8725109

Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice. 2019;155(1):01-10. Doi: https://doi.org/10.1016/j.diabres.2019.107843 PMid:31518657

Diabetes. World Health Organization, Fact sheets. 2019 [Internet] [ Accessed on 2023 August 21]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes

Kulkarni V, Bhaskaran U, Ahmed H, Naimish H, Prakash A, Dahiya B, et al. Diabetic peripheral neuropathy and its determinants among patients attending a tertiary health care centre in Mangalore, India. Vol. 4, Journal of Public Health Research. 2015;4(2):450-462. Doi: https://doi.org/10.4081/jphr.2015.450 PMid:26425491 PMCid:PMC4568420

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109-119. Doi: https://doi.org/10.1016/j.diabres.2021.109119 PMid:34879977 PMCid:PMC11057359

Tesfaye S, Boulton A, Dyck P, Freeman R, Horowitz M. Malik R. et al. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010;33:2285-2293. Doi: https://doi.org/10.2337/dc10-1303 PMid:20876709 PMCid:PMC2945176

Bashar MDA, Verma M. Prevalence and Determinants of Diabetic Peripheral Neuropathy/Foot Syndrome in the Rural Population of North India. Iberoam J Med. 2021;3(1):18-25. Doi: https://doi.org/10.53986/ibjm.2021.0005

Juster-Switlyk K, Smith AG. Updates in diabetic peripheral neuropathy. F1000Res. 2016;5:738-744. Doi: https://doi.org/10.12688/f1000research.7898.1 PMid:27158461 PMCid:PMC4847561

Vibha SP, Kulkarni MM, Kirthinath Ballala AB, Kamath A, Maiya GA. Community based study to assess the prevalence of diabetic foot syndrome and associated risk factors among people with diabetes mellitus. BMC Endocr Disord. 2018;18(1):43-52. Doi: https://doi.org/10.1186/s12902-018-0270-2 PMid:29940924 PMCid:PMC6020220

Herman WH, Pop-Busui R, Braffett BH, et al. Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in Type 1 diabetes: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. Diabet Med. 2012;29(7):937-944. Doi: https://doi.org/10.1111/j.1464-5491.2012.03644.x PMid:22417277 PMCid:PMC3641573

Kamalarathnam S, Varadarajan S. Diabetic peripheral neuropathy in diabetic patients attending an urban health and training centre. J Family Med Prim Care. 2022;11(1):113-119. Doi: https://doi.org/10.4103/jfmpc.jfmpc_470_21 PMid:35309653 PMCid:PMC8930172

Mathiyalagen P, Kanagasabapathy S, Kadar Z, Rajagopal A, Vasudevan K. Prevalence and Determinants of Peripheral Neuropathy Among Adult Type II Diabetes Mellitus Patients Attending a Non-communicable Disease Clinic in Rural South India. Cureus. 2021;13(6):e15493. Doi: https://doi.org/10.7759/cureus.15493 PMid:34268025 PMCid:PMC8261778

Darivemula S, Nagoor K, Patan SK, Reddy NB, Deepthi CS, Chittooru CS. Prevalence and its associated determinants of Diabetic Peripheral Neuropathy (DPN) in individuals having type-2 diabetes mellitus in Rural South India. Indian Journal of Community Medicine. 2019;44(2):88-91.

Kumar M, Paul B, Dasgupta A, Bandyopadhyay L, Roy S, Bandyopadhyay S. Diabetic Peripheral Neuropathy and its Association with Diabetes Self-care: A Clinic-based Study in an Urban Health Centre, Kolkata. Journal of Clinical and Diagnostic Research. 2021;15(2):13-16. Doi: https://doi.org/10.7860/JCDR/2021/45807.14557

Vasanthakumar J, Suwethaa B, Gajula B, Manoli A, Prevalence of diabetic peripheral neuropathy using Michigan Neuropathy Screening Instrument (MNSI) in an urban population in India. Public Health Rev Int J Public Health Res. 2021;8(5):70-77.

Sabaghan, M, Ataee, S, Ataee, M. et al. Diabetic peripheral neuropathy screening and the related risk factors to its prevalence in people with type 2 diabetes. Int J Diabetes Dev Ctries. 2023;43:641-646. Doi: https://doi.org/10.1007/s13410-022-01165-1

Bansal D, Gudala K, Muthyala H, Esam HP, Nayakallu R, Bhansali A. Prevalence and risk factors of development of peripheral diabetic neuropathy in type 2 diabetes mellitus in a tertiary care setting. J Diabetes Investig. 2014;5(6):714-21. Doi: https://doi.org/10.1111/jdi.12223 PMid:25422773 PMCid:PMC4234236

Solanki JD, Doshi RD, Virani NR, Sheth NS, Dhamecha JK, Shah CJ. Prevalence and correlates of vibration perception threshold based diabetic peripheral neuropathy in Gujarati urban population: A cross sectional study. J Family Med Prim Care 2022;11:7055-59. Doi: https://doi.org/10.4103/jfmpc.jfmpc_540_22 PMid:36992993 PMCid:PMC10041324

Dutta SJ, Dutta PK, Dutta A, Ahmed SJ, Sonowal S, Boruah A. Prevalence and risk factors of peripheral neuropathy among young type 2 diabetes mellitus patients attending a tertiary care hospital in upper Assam: A cross-sectional study. J Diabetol. 2023;14:149-56. Doi: https://doi.org/10.4103/jod.jod_22_23

Munyambalu DK, Hildago I, Bafwa YT, et al. Prevalence and grade of diabetic peripheral neuropathy among known diabetic patients in rural Uganda. Front Clin Diabetes Healthc. 2023;3:1001872. Doi: https://doi.org/10.3389/fcdhc.2022.1001872 PMid:36992747 PMCid:PMC10012102

Abdissa D, Hamba N, Kene K, et al. Prevalence and Determinants of Peripheral Neuropathy among Type 2 Adult Diabetes Patients Attending Jimma University Medical Center, Southwest Ethiopia, 2019, an Institutional-Based Cross-Sectional Study. J Diabetes Res. 2020;2020:2920-28. Doi: https://doi.org/10.1155/2020/9562920 PMid:32685561 PMCid:PMC7341394

Cheng Y, Cao W, Zhang J, et al. Determinants of Diabetic Peripheral Neuropathy and Their Clinical Significance: A Retrospective Cohort Study. Front Endocrinol (Lausanne). 2022;13:934020. Doi: https://doi.org/10.3389/fendo.2022.934020 PMid:35957831 PMCid:PMC9360478

Alshammari NA, Alodhayani AA, Joy SS, et al. Evaluation of Risk Factors for Diabetic Peripheral Neuropathy Among Saudi Type 2 Diabetic Patients with Longer Duration of Diabetes. Diabetes Metab Syndr Obes. 2022;15:3007-3014. Doi: https://doi.org/10.2147/DMSO.S364933 PMid:36200063 PMCid:PMC9527617

Tabatabaei-Malazy O, Mohajeri-Tehrani M, Madani S, Heshmat R, Larijani B. The prevalence of diabetic peripheral neuropathy and related factors. Iran J Public Health. 2011;40(3):55-62

Gylfadottir SS, Christensen DH, Nicolaisen SK, et al. Diabetic polyneuropathy and pain, prevalence, and patient characteristics: a cross-sectional questionnaire study of 5,514 patients with recently diagnosed type 2 diabetes. Pain. 2020;161(3):574-583. Doi: https://doi.org/10.1097/j.pain.0000000000001744 PMid:31693539 PMCid:PMC7017941

Pan Q, Li Q, Deng W, et al. Prevalence of and Risk Factors for Peripheral Neuropathy in Chinese Patients With Diabetes: A Multicenter Cross-Sectional Study. Front Endocrinol (Lausanne). 2018;9:617. Doi: https://doi.org/10.3389/fendo.2018.00617 PMid:30455667 PMCid:PMC6230581

Ponirakis G, Elhadd T, Chinnaiyan S, et al. Prevalence and risk factors for diabetic neuropathy and painful diabetic neuropathy in primary and secondary healthcare in Qatar. J Diabetes Investig. 2021;12(4):592-600. Doi: https://doi.org/10.1111/jdi.13388 PMid:32799429 PMCid:PMC8015833

Khawaja N, Abu-Shennar J, Saleh M, Dahbour SS, Khader YS, Ajlouni KM. The prevalence and risk factors of peripheral neuropathy among patients with type 2 diabetes mellitus; the case of Jordan. Diabetol Metab Syndr. 2018;10:8.1-12. Doi: https://doi.org/10.1186/s13098-018-0309-6 PMid:29483946 PMCid:PMC5822644

Kingston C, Aravindan J, Walsalam S. Risk factors associated with peripheral neuropathy among diabetic individuals: a case control study. Int J Community Med Public Health. 2021;8(2):768-774. Doi: https://doi.org/10.18203/2394-6040.ijcmph20210236

Campagna D, Alamo A, Pino A, et al. Smoking and diabetes: dangerous liaisons and confusing relationships. Diabetol Metab Syndr. 2019;11:85-92. Doi: https://doi.org/10.1186/s13098-019-0482-2 PMid:31666811 PMCid:PMC6813988