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Prevalence and management of diabetic neuropathy in secondary care in Qatar
Author(s) -
Ponirakis Georgios,
Elhadd Tarik,
Chinnaiyan Subitha,
Dabbous Zeinab,
Siddiqui Mashhood,
Almuhannadi Hamad,
Petropoulos Ioannis N.,
Khan Adnan,
Ashawesh Khaled A. E.,
Dukhan Khaled M. O,
Mahfoud Ziyad R.,
Murgatroyd Christopher,
Slevin Mark,
Malik Rayaz A.
Publication year - 2020
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3286
Subject(s) - medicine , diabetes mellitus , diabetic foot , logistic regression , type 2 diabetes mellitus , complication , diabetic neuropathy , type 2 diabetes , diabetic foot ulcer , endocrinology
Aims Diabetic neuropathy (DN) is a “Cinderella” complication, particularly in the Middle East. A high prevalence of undiagnosed DN and those at risk of diabetic foot ulceration (DFU) is a major concern. We have determined the prevalence of DN and its risk factors, DFU, and those at risk of DFU in patients with type 2 diabetes mellitus (T2DM) in secondary care in Qatar. Materials and methods Adults with T2DM were randomly selected from the two National Diabetes Centers in Qatar. DN was defined by the presence of neuropathic symptoms and a vibration perception threshold (VPT) ≥ 15 V. Participants with a VPT ≥ 25 V were categorized as high risk for DFU. Painful DN was defined by a DN4 score ≥4. Logistic regression analysis was used to identify predictors of DN. Results In 1082 adults with T2DM (age 54 ± 11 years, duration of diabetes 10.0 ± 7.7 years, 60.6% males), the prevalence of DN was 23.0% (95% CI, 20.5%‐25.5%) of whom 33.7% (95% CI, 27.9%‐39.6%) were at high risk of DFU, and 6.3% had DFU; 82.0% of the patients with DN were previously undiagnosed. The prevalence of DN increased with age and duration of diabetes and was associated with poor glycaemic control (HbA 1c ≥ 9%) AOR = 2.1 (95% CI, 1.3‐3.2), hyperlipidaemia AOR = 2.7 (95% CI, 1.5‐5.0), and hypertension AOR = 2.0 (95% CI, 1.2‐3.4). Conclusions Despite DN affecting 23% of adults with T2DM, 82% had not been previously diagnosed with one‐third at high risk for DFU. This argues for annual screening and identification of patients with DN. Furthermore, we identify hyperglycaemia, hyperlipidaemia, and hypertension as predictors of DN.