Risk determinants of peripheral neuropathy in patients with Type II diabetes mellitus attending follow-Up clinics at University Kebangsaan Malaysia Medical Center (UKMMC): a cross sectional study

Peripheral neuropathy is highly associated with foot complications among diabetics. This study aimedto identify risk factors associated with the development of peripheral neuro­pathy in diabetic patients and their association with degree of severity of peri­pheral neu­ropathy. Across-sectional study was conducted in follow-up clinics at the Uni­versiti Ke­bangsaan Malaysia Medical Centre (UKMMC), Malaysia involving 72 diabetic patients and 19 controls. Exclusion criteria were those with amputated limbs, gross foot deformity and existing peripheral neuropathy. Controls were non diabetics who walked normally, had no history of foot problem and attended the clinic as sub­jects’ companion. Quantita­tive assessment of neuropathy was done using Semmes-Weinstein monofila­ment. Neu­ropathy Disability Score (NDS) were used to quantify se­verity of diabetic neu­ropathy. Spearman’s Rank test and Mann-Whitney test were used to determine correlation be­tween variables and their differences. Logistic regression analysis was used to deter­mine risk factors associated with peripheral neuropathy. The mean HbA1c among di­abetics was 8.6% + 4.1, and mean NDS was 7.0 + 6.0. A total of 79.1% demonstrated various level of neuropathy with presence of callus was asso­ciated with higher NDS scores. Older age (P=0.02), body weight (P=0.03), HbA1c (P=0.005) and duration of di­abetes (P <0.005) showed positive correlation with NDS. Proper foot care program for diabetics should include recognition of the callus, with special emphasis given to those with heavier weight and increasing age.

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