PERIPHERAL NEUROPATHY AMONG PATIENTS WITH TYPE 2 DIABETES USING MICHIGAN NEUROPATHY SCREENING INSTRUMENT

Main Article Content

Ahtar Hussain
Ibrar Ahmad
Muhammad Nawaz Khan
Adnan Zar
Shahid Shahzad

Abstract

 


Objective: To determine the frequency of peripheral neuropathy and associated factors among patients with type 2 diabetes mellitus (T2DM), attending a tertiary care hospital via Michigan Neuropathy Screening Instrument (MNSI).


Methodology: This cross-sectional study was conducted in the department of endocrinology and metabolic dise­aes, Medical Teaching Institute, Lady Reading Hospital Peshawar, from March to December 2019. A total of 365 patients with T2DM were included in the study. All patients were evaluated for peripheral neuropathy using the two sets of MNSI (symptoms and examinations).


Results: Mean age of the patients was 49.0±7.52 years. Mean body mass index (BMI) was 28.1±5.21 kg/m2, and mean glycated haemoglobin (HbA1c) was 10.1±1.56%. There wew 150 (41.10%) males and 215 (58.90) females. Based on the scoring of MNSI questionnaire, 239 (65.5%) had diabetic peripheral neuropathy (DPN) while using MNSI examination 252 (69.0%) had DPN. By combining both questionnaire and examination, DPN was present in 290 (79.5%) of the study participants. The factors associated with DPN after controlling for potential confounders were age of > 50, high levels of total cholesterol (TC) and low density lipoproteins (LDL).


Conclusion: The frequency of DPN was found to be higher in our study population; the burden being high among males. Age, TC and LDL were found to have significant association.

Article Details

How to Cite
1.
Hussain A, Ahmad I, Khan MN, Zar A, Shahzad S. PERIPHERAL NEUROPATHY AMONG PATIENTS WITH TYPE 2 DIABETES USING MICHIGAN NEUROPATHY SCREENING INSTRUMENT. J Postgrad Med Inst [Internet]. 2021 Mar. 31 [cited 2024 Dec. 26];35(1):7-11. Available from: https://jpmi.org.pk/index.php/jpmi/article/view/2735
Section
Original Article

References

Centers for Disease Control and Preven¬tion: National diabetes statistics report: estimates of diabetes and its burden in the United States, 2014. Atlanta, GA: US Dept of Health and Human Services;2014.

N H Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271-81. https://doi. org/10.1016/j.diabres.2018.02.023.

Ijaz M, Ali I, Hussain A. Diabetes mellitus in Pakistan: the past, present, and future. Int J Diabetes Dev Ctries. 2020;40:153- 4. https://doi.org/10.1007/s13410-019- 00754-x

Basit A, Fawwad A, Qureshi H, Shera A. Prevalence of diabetes, pre-dia¬betes and associated risk factors: second National Diabetes Survey of Pakistan (NDSP), 2016–2017. BMJ Open. 2018;8(8):e020961. https://doi. org/10.1136/bmjopen-2017-020961

Singh R, Kishore L, Kaur N. Diabet¬ic peripheral neuropathy: current per¬spective and future directions. Pharma¬col Res. 2014;80:21-35. https://doi. org/10.1016/j.phrs.2013.12.005

Tesfaye S, Boulton AJM, Dyck PJ, Free¬man R, Horowitz M, Kempler P, et al. Diabetic neuropathies: update on defi-nitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010;33(10):2285-93. https://doi. org/10.2337/dc10-1303

Tesfaye S, Selvarajah D. Advances in the epidemiology, pathogenesis and manage¬ment of diabetic peripheral neuropathy. Diabetes Metab Res Rev. 2012;28:8-14. https://doi.org/10.1002/dmrr.2239

Tesfaye S, Vileikyte L, Rayman G, Sindrup SH, Perkins BA, Baconja M, et al. Pain¬ful diabetic peripheral neuropathy: con¬sensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev. 2011;27(7):629-38. https://doi.org/10.1002/dmrr.1225

Ndosi M, Wright-Hughes A, Brown S, Backhouse M, Lipsky BA, Bhogal M, et al. Prognosis of the infected diabetic foot ul¬cer: a 12-month prospective observation¬al study. Diabet Med. 2018;35(1):78-88. http://doi.org/10.1111/dme.13537.

Callaghan BC, Xia R, Banerjee M, de Rekeneire N, Harris TB, Newman AB, et al. Metabolic syndrome components are associated with symptomatic polyneurop¬athy independent of glycemic status. Di¬abetes Care. 2016;39(5):801-7. https:// doi.org/10.2337/dc16-0081

Callaghan B, Feldman E. The metabolic syndrome and neuropathy: therapeutic challenges and opportunities. Ann Neu¬rol. 2013;74(3):397-403. https://doi. org/10.1002/ana.23986

Bril V, Tomioka S, Buchanan RA, Perkins BA. Reliability and validity of the modified Toronto Clinical Neuropathy Score in dia¬betic sensorimotor polyneuropathy. Diabet Med. 2009;26(3):240-6. https:///doi.org/ 10.1111/j.1464-5491.2009.02667.x

Won JC, Kwon HS, Kim CH, Lee JH, Park TS, Ko KS, et al. Prevalence and clini¬cal characteristics of diabetic peripher¬al neuropathy in hospital patients with Type 2 diabetes in Korea. Diabet Med. 2012;29(9):e290-6. https://doi.org/ 10.1111/j.1464-5491.2012.03697.x

American Diabetes Association: 2.Classi¬fication and diagnosis of diabetes: stan¬dards of medical care in diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S13- 27. https://doi.org/10.2337/dc18-S002

Moghtaderi A, Bakhshipour A, Rashi¬di H. Validation of Michigan neuropathy screening instrument for diabetic periph-eral neuropathy. Clin Neurol Neurosurg. 2006;108(5):477-81. https://10.1016/j. clineuro.2005.08.003

Fateh HR, Madani SP, Heshmat R, Larija¬ni B. Correlation of Michigan neuropathy screening instrument, United Kingdom screening test and electrodiagnosis for early detection of diabetic peripheral neu¬ropathy. Journal of Diabetes & Metabolic Disorders. 2015;15(1):8-12. https://doi. org/10.1186/s40200-016-0229-7

Won JC, Kwon HS, Kim CH, Lee JH, Park TS, Ko KS, et al. Prevalence and clini¬cal characteristics of diabetic peripher¬al neuropathy in hospital patients with type 2 diabetes in Korea. Diabet Med. 2012;29(9):e290-6. https://doi.org/ 10.1111/j.1464-5491.2012.03697.x.

Herman WH, Pop-Busui R, Braffett BH, Martin CL, Cleary PA, Albers JW, et al. Use of the Michigan Neuropathy Screening Instrument as a measure of distal sym¬metrical peripheral neuropathy in Type 1 diabetes: results from the Diabetes Con¬trol and Complications Trial/ Epidemiology of Diabetes Interventions and Compli-cations. Diabet Med. 2012;29(7):937- 44. https://doi.org/10.1111/j.1464- 5491.2012.03644.x

Mete T, Aydin Y, Saka M, Cinar Yavuz H, Bilen S, Yalcin Y, et al. Comparison of efficiencies of michigan neuropathy screening instrument, neurothesiome¬ter, and electromyography for diagnosis of diabetic neuropathy. Int J Endocri¬nol. 2013;2013 :821745. htpps://doi. org/10.1155/2013/821745

D’Souza M, Kulkarni V, Unnikrishnan Bhaskaran HA, Naimish H, Prakash A, Ta¬breez S, et al. Diabetic peripheral neurop¬athy and its determinants among patients attending a tertiary health care centre in Mangalore, India. Journal of public health research. 2015;4(2):450-4. https://doi. org/ 10.4081/jphr.2015.450

Lu B, Hu J, Wen J, Zhang Z, Zhou L, Li Y, et al. Determination of peripheral neu¬ropathy prevalence and associated fac¬tors in Chinese subjects with diabetes and pre-diabetes – ShangHai Diabetic neuRopathy Epidemiology and Molecu¬lar Genetics Study (SH-DREAMS). PLoS One. 2013;8(4):e61053. https://doi. org.10.1371/journal.pone.0061053

Khawaja N, Abu-Shennar J, Saleh M, Dahbour SS, Khader YS, Ajlouni KM. The prevalence and risk factors of peripher¬al neuropathy among patients with type 2 diabetes mellitus; the case of Jordan. Diabetol Metab Syndr. 2018;10(1):8-17. https://doi.org/10.1186/s13098-018- 0309-6.

Most read articles by the same author(s)