Javed Ahmed Phulpoto.
Diabetic neuropathy; prevalence and risk factors for severity in patients with type 2 diabetes mellitus attending diabetic clinic of Ghulam Muhammad Mahar medical college hospital, Sukkur.
Professional Med J Jan ;20(4):495-9.

Objective:To estimate the prevalence of diabetic neuropathy (severity wise) and associated risk factors in patients having type 2 diabetes mellitus. Study Design: A cross-sectional study. Place of Study: Diabetes Clinic, Ghulam Mohammad Mahar Medical College Hospital, Sukkur. Duration of Study: From January 2009 to December 2011. Materials and Methods: A patients based sample of 1401 persons with diabetes (identified as per the WHO criteria) underwent comprehensive eye examination including direct & 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. Results: 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). Conclusions: 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.

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